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.
Aphallia Penis or penile agenesis is a condition where no penis is found in a man. This is caused by the failure of the development of the genital tubercle. This disorder is very rare, with an estimated incidence of 1 in 10 million to 30 million births. Treatment for aphallia must begin as early as possible, based on careful evaluation and rapid sex determination by the clinical team, including plastic surgeons, psychologists, endocrinologists, and urologists. Case: A man, 22 years-oldpatient, from Bali came to the Reconstructive and Aesthetic Plastic Surgery Polyclinic Dr. Soetomo, Surabaya with the main complaint of not having male genitals from birth. The patient has been urinating through a hole under the clear yellow scrotum. Three operations have been carried out to reconstruct the penis. iscussion: In this case, the patient had reconstruction for aphalia penis. Three operations were performed. The first is a uretroplasty surgery in which the operation of the removal of the external urethra meatus from the perineal to the penoscrotal area The second stage of surgery was performed neorethra exploration in the antebrachial region, external genital reconstruction with radial forearm free flap sinister tubes, silicone implant insertions, Neophalus insertions, and split thickness skin grafts to close the defects in the antebrachia. In third stage surgery, uretroplasty surgery is performed again to move the external urethra meatus in the penoscrotal distal to the penis. Conclusions: Treatment for aphallia must begin as early as possible, based on careful evaluation and rapid sex determination by the clinical team, including plastic surgeons, psychologists, endocrinologists and urologists. After sex determination and consultation with a psychologist, after adulthood can be carried out a total phallic reconstruction using radial artery-based free forearm flaps or with pedicled anterolateral thigh flaps, where this method is known as a simple, fast, and well-reported method of phallus reconstruction.
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