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Background: Wound care with modern dressings that have been widely used takes time to achieve healing. Therefore, Epidermal Growth Factor (EGF) and Platelet-Rich Plasma (PRP) are developed in wound healing therapy. EGF as the primary growth factor examines whether it is sufficient to represent the role of other growth factors in PRP. EGF is also chosen because of its ease of provision and longer shelf life compared to PRP. This study evaluates the (EGF) representing the role of other growth factors contained in PRP.  Methods: The study was performed on 66 full-thickness wounds in 6 groups of 36 healthy male Oryctolagus cuniculus rabbits. Four treatment groups were given EGF and PRP therapies. Two control groups were given no treatment. Half of the groups were evaluated on the fifth day and the rest on the fourteenth day. Assessment on the clinical macroscopic and histopathological numbers of fibroblasts, capillary blood vessels, and type III collagen fibers were stained with Hematoxylin Eosin (HE) and Masson's Trichrome. Data were analyzed using SPSS version 23 for Windows.Results: There was a statistically significant difference in fibroplasia (p=0.014; p=0.018) on the fifth and fourteenth days. However, there was no significant difference in angiogenesis (p=0.183; p=0.524) or collagenization (p=0.218; p=0.278) on the fifth and fourteenth day. On the fifth day, the number of capillary vessels was highest in the PRP groups (10.60±4.13), and the ratio of type III collagen fibers (53.00±13.00) was the highest in the EGF group. On the fourteenth day, the number of capillaries and the ratio of type III collagen fibers was the highest in the EGF groups (77.00±16.00). Conclusion: EGF greatly increases the speed of macroscopic healing, accelerates fibroplasia, induces angiogenesis, and is also involved in collagen deposition compared to PRP administration, especially when compared to untreated wounds.

Background: A wound is a discontinuity of any bodily tissue due to various causes. Every wound of any severity could result in problems related to its healing process, such as scar tissue formation. According to the duration of its healing process, wound is divided into 2 categories: acute wound that takes approximately 3-4 weeks to heal and chronic wound that needs 4-6 weeks and resulted from inappropriate healing of the acute wound. Tretinoin's use in wound healing has been controversial for more than 40 years. Topical Tretinoin has keratolytic effect that stimulates fibroplasia and epithelization on full-thickness wounds. On the other hand, single administration along with long-contact topical Tretinoin has an irritative effect that could delay healing due to continuous inflammation. This study aims to explore the effectiveness of single administration compared to repeated administration of topical Tretinoin in full-thickness acute wound healing on rats at Faculty of Veterinary Medicine, Airlangga University, Surabaya. Methods: This experimental study involved 27 male rats which were randomly divided into 3 groups: control (A), single-administration (B), and repeated-administration (C). Full-thickness wound size 20 mm in diameter was made on the skin of each rat. On group A, wounds were covered with Tulle and transparent dressing. On group B, wounds were treated with lidocaine 2% and tretinoin solution 0,05% in single administration, while the same treatment was given repeatedly on group C for 4 days straight. Evaluation was done microscopically on day 5 according to epithelization phase on wound healing with hematoxylin and eosin (H&E) staining. Results: The result from the calculation showed that group C obtained a significantly higher average number of fibroblast cells count compared to the treatment group A and B. The average number of fibroblast cells in treatment group B was three times higher than the number of fibroblast cells in treatment group A, while the average number of fibroblast cells in treatment group C was three times the number of fibroblast cells in treatment group B. From the statistic, it was proven that the regular application of 0.05% topical tretinoin solution in a full-thickness wound (Group C) has shown a significant increase in the number of fibroblasts during the proliferative phase. Conclusion: A frequent administration of 0.05% topical tretinoin solution resulted in a higher number of fibroplasia improvements compared to once administered in full thickness acute wound healing, however it did not result in epithelialization on day 5.

Background: Fractures of the hard palate are infrequent. They are found in less then 10% of patients with midfacial fractures. They practically never occur in isolation and are usually part of alveolar process fractures or more complex midfacial fractures of the Le Fort type. Treatment of palatal fractures is planned and performed with the goal of restoring the transverse width of the palate, the anteroposterior projection of the maxillary arch, and the patient’s pretraumatic occlusal plane, as well as maintaining horizontal stability of the midface.Case Presentation: Reporting patient female 17 years old with panfacial fracture due to traffic accident. There was slight epidural haemorrhage on frontal area. The fractures are on upper face, midface, and lower face including the hard palate. We performed open reduction internal fixation on palate to correct the arch of the upper jaw. The other fracture site can be corrected easier. The approaches that we done are bicoronal, subsilier, and intraoral. The patient was successfully treated using bottom-up and outside-in sequence by accessing all facial injuries. Postoperatively, radiograph examination revealed good reduction and fixation of titanium plates, and physical examination revealed good functional and aesthetic outcomes.Conclusion: Palate fractures are relatively uncommon and are associated with significant rates of malocclusion and wound complications. These injuries are typically managed with plate fixation of the alveolar ridge with variable approaches to the palatal vault

Background : Constricted head or cloverleaf deformity in Crouzon syndrome is a severe form of the syndrome involving trilobed coronal and lambdoid synostosis. Crouzon syndrome with acanthosis nigricans is distinct from the classic Crouzon syndrome, characterized by thick and dark skin in body folds. The major problems resulting from constricted head are related to craniostenosis, orbitostenosis developing from abnormalities of the skull base associated with progressive rise in intracranial and intraorbital pressures which could progress to hydrocephalus and cerebellar herniation. Case: Two cases with severe Crouzon syndrome were reported. The first was a five month old girl associated with acanthosis nigricans and the other was a sixteen month old boy, both whose phenotypic expressions were at the extreme severe end of the disease spectrum. On examination there was serious corneal exposure, visual loss, severely narrow head, midface hypoplasia, and beaked nose. CT scan showed typical cloverleaf skull, expanded middle cranial fossa, foreshortened anterior and posterior fossae and honeycomb appearance in the occiput involving pansutural synostosis and extensive copper beaten deformity from the high intracranial pressure . Both were complicated with hydrocephalus requiring ventriculoperitoneal shunt. This required an arduous effort in releasing the brain from the multiply punctured calvaria, avoiding excessive dural tear and bleeding and ultimately preserving the brain. Excessive bleeding was also caused by the raised ICP. Both patients are planned to undergo occipital expansion three months later. Conclusion: Severely constricted head in Crouzon syndrome is an extreme manifestation and late stage of the syndrome which not only will result in irreversible complication but will require meticulous surgical technique.

Background:The wound healing process is closely related to wound care techniques which consist of cleansing, debridement and dressings. In infected wounds, washing with a wound washing solution is expected to reduce the colony of germs and to eradicate the infection. One of the important pathogens in wound is Pseudomonas aeruginosa. In this study we will compare the use of normal saline, chlorhexidinecetrimide, and prophylbetaine-polyhexanide as wound washing solutions for wounds contaminated with Pseudomonas aeruginosa. Methods: Twenty-seven mice were divided into 3 groups: normal saline, chlorhexidine-cetrimide, and prophylbetaine-polyhexanide group. The wound was made on the mice's back then the Pseudomonas aeruginosa germ was inoculated on the wound. Four hours later, the wound was irrigated with the wound washing solution according to its group. Tissue culture will be taken 18 hours after washing. Result : Propylbetaine-Polihexanide is the most effective wound washing solution on Pseudomonas aeruginosa contaminated wound compare to Normal Saline and Chlorhexidine-Cetrimide. Although, there is no significant difference in the number of Pseudomonas aeruginosa bacteria on the wound bed after washing with Normal Saline, Chlorhexidine-Cetrimide, and Propylbetaine-Polihexanide.

Facial clefts are rare facial anomalies. Among them, oro-ocular cleft remains a challenging malformation due to ectropion of the inferior palpebra which can constitute an emergency when the patient's globe is exposed leading to exposure keratitis and blindness. Here we report surgical procedures to correct lower eyelid ectropion using tarsoconjunctival-skin flap performed on 2 cases. In conclusion, tarsoconjunctival-skin flap can be provided to effectively correct lower eyelid ectropion and is a better option when nose correction is not involved simultaneously.

Pendahuluan. Kehilangan kulit yang terlalu luas perlu jaringan penutup untuk mengatasinya, salah satu pilihan untuk menutup luka tersebut dengan melakukan tindakan skin grafting. Berdasarkan data IRJ Bedah Plastik Rekonstruksi dan Estetik RSUD Dr. Soetomo dalam 1 tahun (2017-2018) didapatkan pada 26 dari 50 kasus donor skin graft mengalami penyembuhan yang lebih dari waktu penyembuhan normal. Metode penyembuhan luka telah mengalami perkembangan beberapa tahun terakhir, salah satunya mulai dikenal peran platelet-rich fibrin (PRF).Metode. Penelitian ini merupakan penelitian dengan desain meta-analisis yang bersifat kuantitatif. Sumber data dari penelitian ini melalui penelusuran literatur di pencarian elektronik dengan menggunakan keyword pencarian literature. Database yang digunakan adalah Medline dan Pubmed antara tahun 2005-2020.Hasil. Seleksi literatur didapatkan 5 studi, dengan 3 studi subjek menggunakan donor split thickness skin graft dan 2 studi menggunakan donor free gingival graft. Dalam 3 studi menyebutkan pemberian platelet-rich fibrin (PRF) dapat mempercepat waktu penyembuhan dan epitelisasi. Hasil meta analisis menunjukkan tidak ada perbedaan antara kelompok pemberian platelet-rich fibrin (PRF) dan kelompok kontrol dalam proses epitelisasi pada donor skin graft (summary effect 1.30, 95% CI -0.42 – 3.02). Kesimpulan. Bukti - bukti preklinik berdasarkan studi meta-analisis ini menunjukkan bahwa tidak ada pengaruh signifikan terhadap pemberian platelet-rich fibrin (PRF) pada donor skin graft dalam kecepatan epitelisasi