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Kulit kering merupakan salah satu masalah penuaan yang paling umum. Perubahan pada sistem integumen meningkatkan risiko peradangan dan infeksi kulit pada lansia. Peradangan dan infeksi kulit sering terjadi pada permukaan tubuh yang terlihat. Karya ilmiah ini bertujuan untuk menjelaskan asuhan keperawatan pada lansia dengan masalah gangguan integritas kulit melalui manajemen pruritus yaitu personal hygiene dan pemberian pelembab Tea Tree Oil di Panti Sosial Tresna Werdha Budi Mulia 4 Ciracas. Klien berusia 60 tahun merupakan salah satu lansia yang tinggal di wisma Merpati PSTW Budi Mulia 4 Ciracas. Klien mengalami penyakit kulit berupa eksim kering (xerosis) dan pruritus pada area kaki bagian bawah. Kulit kaki klien tampak kering, kasar, bersisik, terdapat eritema dan tampak kehitaman. Hasil akhir menunjukkan adanya peningkatakan pada rasa nyaman yang ditandai dengan berkurangnya gatal yang dirasakan oleh klien dan derajat eritema tampak berkurang setelah dilakukannya personal hygiene dan pemberian pelembab Tea Tree Oil. Pemberian pelembab Tea Tree Oil dapat dilalukan sebagai penyembuhan infeksi kulit yang disebabkan oleh mikroorganisme. Sehingga dalam hal ini, personal hygiene dan pelembab Tea Tree Oil dapat mengatasi masalah kulit kering dan meredakan pruritus. Panti Sosial Tresna Werdha diharapkan dapat mendukung ketersediaan alat dan bahan dalam perawatan personal hygiene, seperti sabun antiseptik atau sabun dengan pH balance, handuk bersih untuk masing-masing lansia, dan pelembab khusus yang dapat mengatasi masalah integritas kulit pada lansia.

 

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Dry skin is one of the most common aging problems. Changes in the integumentary system increase the risk of skin inflammation and infection in the elderly. Skin inflammation and infection often occur on the visible surface of the body. This scientific work aims to explain nursing care for elderly with skin integrity problems through pruritus management, namely personal hygiene and tea tree oil moisturizer at Panti Sosial Tresna Werdha Budi Mulia 4 Ciracas. The 60 year old clien is one of the elderly who live in the Merpati guesthouse of PSTW Budi Mulia 4 Ciracas. The client experiences skin disease in the form of dry eczema (xerosis) and pruritus in the lower leg area. The client’s leg skin looked dry, rough, scaly, had erythema, and looked blackish. The final results showed an increase in confort which was marked by the reduction of itching felt by the client and the degree of erythema seemed to decrease after personal hygiene and the application of Tea Tree Oil moisturizer. Tea Tree Oil moisturizer can be applied as a treatment for skin infections caused by microorganisms. So in this case, personal hygiene and Tea Tree Oil moisturizer can overcome dry skin problems and relieve pruritus. Tresna Werdha Social Institutions are expected to support the availability of tools and materials in personal hygiene care, such as antiseptic soap or soap with a pH balance, clean towels for each elderly person, and special moisturizers that can overcome skin integrity problems in the elderly.

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Penyakit hirschsprung (Hirschsprung’s Disease) merupakan kelainan kongenital pada sistem gastrointestinal yang umum terjadi pada anak. Salah satu komplikasi yang umum dijumpai pasca pembedahan definitif duhamel pull-through yakni peningkatan frekuensi dan perubahan konsistensi feses sehingga berisiko lebih tinggi mengalami gangguan integritas kulit di area yang tertutupi popok. Masalah gangguan integritas kulit juga dipengaruhi oleh pengetahuan dan perilaku orang tua yang tidak tepat dalam membersihkan kulit sehingga merusak kulit di area sekitar perianal dengan ditandai adanya kemerahan, papula/pustula, bahkan erosi. Perawatan kulit yang tepat diperlukan untuk mencegah perluasan area dan menangani masalah integritas kulit melalui pendekatan ABCDE (air, barrier, cleansing, diapering, dan education). Penerapan konsep ini yang dilakukan pada anak B menunjukkan hasil yang cukup signifikan dengan menggunakan instrumen DDSIS dari skor 6 menjadi 3 terhadap berkurangnya derajat gangguan integritas kulit setelah dilakukan intervensi dengan pendekatan konsep ABCDE. Hasil penerapan ini dapat digunakan sebagai masukan bagi institusi pendidikan keperawatan, penelitian keperawatan, maupun institusi rumah sakit.

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Hirschsprung's Disease is a common congenital abnormality of the gastrointestinal system that occurs in children. One of the common complications observed after definitive Duhamel pull- through surgery is an increase in the frequency and changes in the consistency of feces, which can lead to a higher risk of skin integrity problems in the diapered area. Skin integrity problems are also influenced by inappropriate parental knowledge and behavior in cleaning the skin, which can cause damage to the skin around the perianal area, resulting in redness, papules/pustules, and even erosion. Proper skin care is essential to prevent the expansion of affected areas and address skin integrity problems. The ABCDE approach, which stands for air, barrier, cleansing, diapering, and education, has been shown to be effective in preventing skin integrity problems in children. This study applied the ABCDE approach to child B and observed significant results with a decrease in the DDSIS instrument score from 6 to 3 after intervention. The findings of this study suggest that the ABCDE approach can be used as a guide for nursing education, research, and hospital institutions to improve skin care practices and prevent skin integrity problems in children.

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Xerosis dan pruritus adalah salah satu masalah kulit yang paling sering terjadi pada lansia sebagai respon fisiologis penuaan. Xerosis merupakan kondisi kulit kering akibat kurangnya kadar air pada stratum korneum di epidermis. Ekstremitas bawah merupakan salah satu bagian tubuh yang paling sering mengalami xerosis dibandingkan dengan bagian tubuh lainnya. Xerosis seringkali disertai pruritus yang memicu garukan berlebih dan menyebabkan kerusakan sekunder pada kulit. Penulisan ini bertujuan untuk melihat efek pelembab yang mengandung urea pada kulit kering pada lansia. Penulisan ini berfokus pada intervensi perawatan kaki dengan menggunakan pelembab yang mengandung urea selama 20-30 menit setiap sesinya selama 7 hari. Urea telah terbukti sebagai natural moisturizing factors (NMF) dapat mengurangi transpepidermal water loss (TEWS) pada kulit kering dan sebagai agen antimikroba serta antipruritus untuk mengurangi rasa gatal. Hasil evaluasi intervensi menunjukkan penurunan derajat kulit kering setelah dilakukan intervensi perawatan kaki menggunakan pelembab yang mengandung urea pada lansia dengan kulit kering. Perawat general diharapkan dapat menerapkan perawatan kaki menggunakan pelembab yang mengandung urea sebagai intervensi keperawatan untuk mengatasi masalah integritas kulit pada lansia.

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Xerosis and pruritus are the most common skin problems in the elderly as a physiological response to aging. Xerosis is a dry skin condition due to lack of water content in the stratum corneum in the epidermis. The lower extremity is one of the parts of the body that most often experiences xerosis compared to other parts of the body. Xerosis is often accompanied by pruritus which triggers excessive scratching and causes secondary damage to the skin. This paper aims to see the effect of a moisturizer containing urea on dry skin in the elderly. This paper focuses on foot care interventions using a moisturizer containing urea for 20-30 minutes each session for 7 days. Urea has been proven as a natural moisturizing factor (NMF) to reduce transpepidermal water loss (TEWS) in dry skin and as an antimicrobial and antipruritic agent to reduce itching. The results of the intervention evaluation showed a decrease in the degree of dry skin after the foot care intervention using a moisturizer containing urea in the elderly with dry skin. General nurses are expected to apply foot care using a moisturizer containing urea as a nursing intervention to address skin integrity problems in the elderly.

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"Luka yang lama sembuh pada pasien pasca operasi masih menimbulkan keluhan nyeri dan menghabiskan biaya yang besar. Terapi standar topikal hidrokoloid masih membuat rasa tidak nyaman karena gel berwarna kuning, kental, dan menimbulkan bau yang tidak sedap. Terapi topikal dengan royal jelly (RJ) yang berasal dari Yamada Bee Farm (YBF), Jepang terbukti dapat mempercepat penyembuhan luka, namun belum pernah ada penelitian yang menggunakan RJ yang berasal dari Sragen, Indonesia. Penelitian ini bermaksud membandingkan efek RJ Sragen dengan RJ YBF yang diberikan pada luka pasca operasi.Penelitian ini adalah penelitian eksperimental laboratorium prospektif. Penelitian dilakukan di Animal Research Facilities Indonesian Medical Education and Research Institute (ARF-IMERI) FKUI dan Departemen Patologi Anatomik FKUI-RSCM. Penelitian dilakukan pada tanggal 14 Februari 2022-30 Agustus 2023. Penelitian dilakukan pada tikus jantan sprague dawley (SD) dan manusia. Setiap tikus terdapat 4 kelompok perlakuan yaitu: tanpa perlakuan, hidrokoloid, gel RJ Sragen 10% dan gel RJ Yamada Bee Farm (YBF) 10%. Penyembuhan luka diamati secara makroskopik dan mikroskopik (sel inflamasi, kolagen, epitelisasi, angiogenesis, TNF-α serta TGF-β) di hari ke-1, ke-3, ke-5, ke-12. Pada manusia, perlakuan diberikan sampai hari ke-21 dan difoto lukanya di hari ke-7, ke-14, dan ke-21. Ada 3 kelompok perlakuan pada manusia yaitu kelompok hidrokoloid, kelompok gel RJ Sragen 10%, dan gel RJ gel YBF 10%. Semua penilaian dihitung dengan Image J. Selanjutnya dilakukan uji general linear model repeated measures ANOVA dan analisis semikuantitatif.Aplikasi gel RJ Sragen 10% dan hirokoloid dapat menekan sel inflamasi dan menurunkan ekspresi TNF-α dan TGF-β. Walaupun kinetika perubahan jumlah sel inflamasi serta penekanan ekspresi TNF-α dan TGF-β pada aplikasi keduanya sama, namun ekspresi TNF-α dan TGF-β lebih ditekan pada aplikasi gel RJ Sragen 10%. Pada parameter kolagen dan epitelisasi kelompok gel RJ Sragen 10% dan hidrokoloid menunjukkan kemampuan yang sama. Pada parameter angiogenesis, kelompok gel RJ Sragen 10% menunjukkan peningkatan angiogenesis lebih banyak dibandingkan dengan hidrokoloid (p < 0,0001). Hal ini mungkin disebabkan beberapa sitokin seperti VEGF dan BFGF juga berperan. Penutupan diameter luka tikus terlihat lebih cepat satu hari (hari ke-10) pada kelompok gel RJ Sragen 10% dibandingkan kelompok hidrokoloid (hari ke-11) pada pengamatan makroskopik.

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Chronic wound healing in post-operative patients still provoking pain complaints and spending a lot of money. Topical hydrocoloid as a standard therapy still makes you uncomfortable because the gel is yellow, thick, and causes an unpleasant odour. Topical therapy with royal jelly (RJ) originating from the Yamada Bee Farm (YBF), Japan has been shown to accelerate wound healing, but there has never been a study using RJ originating in Sragen, Indonesia. This study is intended to compare the effects of RJ Sragen with RJ YBF given to post-operative wounds.

This research is a prospective laboratory experimental research. The research was conducted at Animal Research Facilities Indonesian Medical Education and Research Institute (ARF-IMERI) FKUI and the Department of Anatomic Pathology FKUI-RSCM. The research was done on male sprague dawley mice (SD) and humans. Each rat has four treatment groups: untreated, hydrocoloid, RJ Sragen 10% gel and RJ Yamada Bee Farm (YBF) 10% gel. The wound healing was observed macroscopically and microscopically (inflammatory cells, collagen, epithelization, angiogenesis, TNF-α and TGF-β) on day 1, 3rd, 5th, 12th. In humans, the treatment was given until day 21 and the wound is photographed on day 7, 14th and 21st. There were three treatment groups in humans: the hydrocolloid group, the RJ gel group Sragen 10%, and the YBF gel RJ 10%. All assessments were calculated with Image J. Then the general linear model repeated measures ANOVA and semi-quantitative analysis were performed.

Although the kinetics of the change in the number of inflammatory cells as well as the suppression of TNF-α and TGF-β expressions in both applications were the same, the expression of RJ Sragen, as well as TGF-β, was more suppressed in the application of the 10% Sragen RJ gel. On collagen and epithelization of the 10% Sragen and hydrocoloid gels, the same ability was shown. On the angiogenesis parameters, the 10% sragen gels show a greater increase in angiogenesis compared to the hydrocoloid (p < 0,0001). This is probably because some cytokines, like VEGF and BFGF, also play a role. The closure of the diameter of the wound of the rat was seen more quickly one day (10th day) in the RJ Sragen gel group 10% compared to the hydrocoloid group (11th day), in macroscopic observations."

"[ABSTRAKPendahuluan :Fraktur Midface merupakan fraktur yang sering terjadi dapat dapat memberikan efek baik dari segi estetik dan fungsi. Fraktur Midface yang tidak ditangani dengan baik akan merubah bentuk wajah menjadi tidak proporsional, salah satunya wajah yang menjadi lebih lebar dan panjang, terdapat depresi malar. Tata laksana dengan reposisi segmen fraktur dan fiksasi interna merupakan pilihan utama.Metode :Data yang diambil dari status estetik dengan menggunakan studi cross sectional pada pasien dengan fraktur midface sebelum operasi ORIF didapatkan di rekam medis, dan data setelah opeasi ORIF didapatkan dari follow up (4 years), kemudian dilakukan pengukuran dari proyeksi vertical, horizontal dan warm?s view .Hasil :Berdasarkan analisis fotografi dari proyeksi vertikal didapatkan 3 pasien memiliki proporsi muka yang baik, 3 pasien memiliki proporsi wajah yang baik dikarenakan perbedaan rata-rata. Berdasarkan analisis fotografi dari proyeksi horizontal didapatkan 3 pasien memiliki panjang muka yang berbeda, 2 pasien memiliki dystopia, 1 pasien memiliki enophtalmus. Berdasarkan analisi fotografi dari proyeksi worm?s eye didapatkan 4 pasien memiliki depresi malar eminensMengenai hasil estetika, didapatkan 4 pasien (66,6 %) puas dengan simetrisitas wajah setelah operasi. 2 pasien (33,3 %) mengeluhkan tidak puas dengan penampilan akhir setelah operasiKesimpulan :Untuk dapat mengevaluasi hasil operasi ORIF di Divisi Bedah Plastik Rumah Sakit Ciptomangunkusumo. Tidak hanya dibutuhkan registrasi data awal yang baik, tetapi juga dibutuhkan sarana dan fasilitas untuk mendapatkan evaluasi jangka panjang pada pasien terutama lokasi pasien yang jaraknya jauh dari lokasi rumah sakit.

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ABSTRACTBackground :Midface fracture is a fracture that often occurs may be able to give a good effect in terms of aesthetics and functionality. Midface fracture that is not handled properly will change the shape of the face become disproportionate, one of which face becomes wider and longer, there is a malar depression. The management of the segment repositioning fracture and internal fixation is the main option.Methods:Data taken from the status aesthetic using cross sectional study in patients with fractures midface before surgery ORIF obtained in medical records, and the data after opeasi ORIF obtained from follow-up (4 years), then the measurement of the projected vertical, horizontal and warm's view.Result:Based on the photographic analysis of the vertical projection obtained 3 patients have a good proportion of the face, 3 patients had good facial proportions due to differences in average. Based on the photographic analysis of horizontal projection obtained 3 patients had a different face long, 2 patients had a dystopia, 1 patient had enophtalmus. Based on the photographic analysis of the worm's eye projection obtained 4 patients had a malar depression eminens.Regarding the aesthetic results, obtained four patients (66.6%) are satisfied with simetrisitas face after surgery. 2 patients (33.3%) complained of is not satisfied with the final appearance after surgeryConclusions:To be able to evaluate the results of ORIF surgery in the Division of Plastic Surgery Hospital Ciptomangunkusumo. Not only the data registration needed a good start, but also the infrastructure and facilities needed to obtain a long-term evaluation of the patients, especially the location of patients that were located far from the location of the hospital, Background :Midface fracture is a fracture that often occurs may be able to give a good effect in terms of aesthetics and functionality. Midface fracture that is not handled properly will change the shape of the face become disproportionate, one of which face becomes wider and longer, there is a malar depression. The management of the segment repositioning fracture and internal fixation is the main option.Methods:Data taken from the status aesthetic using cross sectional study in patients with fractures midface before surgery ORIF obtained in medical records, and the data after opeasi ORIF obtained from follow-up (4 years), then the measurement of the projected vertical, horizontal and warm's view.Result:Based on the photographic analysis of the vertical projection obtained 3 patients have a good proportion of the face, 3 patients had good facial proportions due to differences in average. Based on the photographic analysis of horizontal projection obtained 3 patients had a different face long, 2 patients had a dystopia, 1 patient had enophtalmus. Based on the photographic analysis of the worm's eye projection obtained 4 patients had a malar depression eminens.Regarding the aesthetic results, obtained four patients (66.6%) are satisfied with simetrisitas face after surgery. 2 patients (33.3%) complained of is not satisfied with the final appearance after surgeryConclusions:To be able to evaluate the results of ORIF surgery in the Division of Plastic Surgery Hospital Ciptomangunkusumo. Not only the data registration needed a good start, but also the infrastructure and facilities needed to obtain a long-term evaluation of the patients, especially the location of patients that were located far from the location of the hospital]"

"Smith and Nesi’s ophthalmic plastic and reconstructive surgery, third edition has taken the best of the field’s classic reference text and expanded upon it, continuing its reputation as the foremost guide to the subspecialty. Every practitioner of plastic and reconstructive surgery will find useful information in this comprehensive, in-depth text, including an update on the changes and advances of the last several years and a new section on pediatric consideration. Detailed chapters on ophthalmic anatomy are also included, as well as sections on eyelid dermatology, socket surgery, and cosmetic surgery. Every consideration has been made by Dr. Nesi and his co-editors to cover every aspect important to the ophthalmic plastic surgeon.Features, fully updated and revised edition of Smith’s ophthalmic plastic and reconstructive surgery, comprehensive text with detailed chapters that cover all aspects of the subject matter, and more than 1700 figures and 77 chapters."

"Salah satu pergeseran paradigma terbesar dalam dunia kedokteran saat ini adalah pergeseran model pelayanan kesehatan dari disease-centric care menjadi patient-centric care. Bedah plastik rekonstruksi dan estetik menjadi spesialis kedokteran yang membutuhkan implementasi model tersebut, didorong oleh rendahnya tingkat konversi pasien di tahap pre-operatif, teknik operasi tanpa panduan di tahap intra-operatif, dan masih tingginya tingkat permintaan revisi operasi di tahap pasca-operatif. Saat ini, implementasi patient-centric care melalui penggunaan model spesifik-pasien, yaitu replika anatomis bagian wajah atau tubuh pasien yang dapat digunakan dokter sebagai simulator bedah dan alat visualisasi pasien, menjadi instrumen paling efektif dalam memecahkan masalah tersebut. Namun, model spesifik-pasien yang ada di pasaran saat ini masih menggunakan modalitas pemindai yang rumit, mahal, dan model spesifik-pasien masih sulit diakses khususnya untuk negara berkembang. Oleh karena itu, dalam skripsi ini penulis mengusulkan sebuah rancang bangun model spesifik-pasien yang dikhususkan pada bagian maxillofacial untuk pemandu operasi dengan metode pemindaian 3D berbasis smartphone dengan sensor TrueDepth™ dan pemodelan 3D berbasis Growing Neural Gas yang jauh lebih sederhana, murah, dan terjangkau. Akurasi model spesifik-pasien yang dirancang diukur nilai indeks similaritasnya sebesar 0,2101 terhadap topologi wajah subjek asli yang dinilai cukup akurat.

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One of the biggest paradigm shifts in medicine today is the shift in health care models from “disease-centric care” to “patient-centric care”. Plastic and aesthetic surgery become one of the medical field who urgently need this model implementation, driven by the low conversion rates of patients in pre-surgery phase, unguided surgery technique encountered in intra-operative phase, and high surgery revision demand in postoperative phase. Currently, patient-centric care implemented through patient-specific models, which is an anatomical replica of the patient's face or body which surgeons can use as a surgical simulator and patient visualization tool, this instrument proven to be the most effective in solving those mentioned problems. However, patient-specific models on the market today still use complex and expensive scanning modalities and the patient-specific models that are still difficult to access, especially in developing countries. Therefore, in this research the author propose a patient-specific model prototype for surgical guidance in maxillofacial region with 3D scanning methodology which utilized smartphone with TrueDepth™ sensor and Growing Neural Gas-based 3D modelling methodology which more simple, low-cost, and accessible. The accuracy of patient-specific model measured in similarity index against the subject’s real face topology resulted in the amount of 0,2101 which sufficiently accurate."