Hasil Pencarian  ::  Simpan CSV :: Kembali

"[Latar belakang: Eksisi dini eskar luka bakar yang diikuti dengan autograft merupakan terapi utama pada luka bakar. Meskipun efektif, debridement dengan pembedahan secara teknis sulit dan mempunyai komplikasi. Debridement secara enzimatik menggunakan bromelain dapat mempreservasi epitelisasi dan tidak merusak jaringan sehat. Tujuan penelitian ini adalah menilai efek enzim bromelain produksi perusahaan lokal dikombinasi dengan hidrogel pada luka bakar dalam tikus. Metode penelitian: Tikus dibagi atas 3 kelompok yaitu kelompok 1 (luka bakar tanpa intervensi), kelompok 2 (luka bakar yang diberi gel), kelompok 3 (luka bakar yang diberi gel bromelain 10%). Kemudian masing-masing kelompok dibagi atas kelompok berdasarkan waktu 0,2,4,8,12,24 jam Reduksi eskar luka bakar difoto kemudian diukur menggunakan imageJ v 1.48®. Jaringan luka dibiopsi setelah binatang diterminasi dan diperiksa zone lisis, tipe dan derajat inflamasi. Hasil penelitian: Reduksi eskar luka bakar sedikit meningkat pada grup 1 dan 2 pada jam ke- 4 dan 24 (rata-rata 1.05% dan 2.2% pada jam ke-4, 3.52% and 4.13% pada jam ke-24). Gel bromelain sangat aktif merusak eskar luka bakar pada 4 jam pertama dan mencapai puncak pada jam ke-8 dan 12. Secara statistik terdapat perbedaan reduksi eskar dan zona lisis antara gel bromelain dan kontrol (p=0.000). Tipe inflamasi yang dominan pada semua grup adalah tipe campuran dan derajat inflamasi adalah sedang dan berat. Kesimpulan: Penetrasi gel bromelain 10% untuk mendegradasi eskar luka bakar optimal pada jam ke-8 dan ke 12, efektif untuk debridement eskar luka bakar dan tidak merusak jaringan sehat sekitarnya. Persentase PMN hampir sama pada semua grup dan secara statistik tidak terdapat perbedaan yang bermakna antara kelompok intervensi dan kontrol (p=0.47)., Background: Early excision burn eschar followed by autografting is a cornerstone of modern burn therapy. While effective, surgical debridement of the burned tissue is technically difficult and may cause considerable complications. Enzymatic debridement using bromelain can preserve the spontaneous epithelialisation potential and reduce the added injury to the traumatised tissue. The aim of the study was to assess the implication of bromelain enzyme that produce by local company combined with hydrogel on full-thickness skin burns of rats. Methods: Rats were divided in 3 group consist of group 1 (burn wound without intervention), group 2 (burn wound was treated with hydrogel), grup 3 (burn wound was treated with bromelain gel 10%). Each group was divided into subgroups time 0, 2, 4, 8, 12, 24 hours after intervention. The reduction of eschar surface area were measured by photographic documentation of the burns with ImageJ v1.48®. Histopathology preparations were made after terminated to measured lytic zone thickness, type and degree inflammation. Results : Burn eschar surface area reduction slightly increased in group 1 and 2 at 4 and 24 hours (mean 1.05% and 2.2% at 4 hours, 3.52% and 4.13% at 24 hours). Bromelain gel were most actively breaking down burn eschar during the first 4 hours. Peak of burn eschar reduction and lytic zone in the hours between 8 and 12 hours. There are statistically significant difference byrn eschar reduction and lytic zone between bromelain gel and control (p=0.000). The type of inflammation was a mixed inflammation type dominated and the degree of inflammation was moderate and severe in all group. Conclusion : Penetration of bromelain gel 10% optimally at 8 and 12 hours to degradation of the burn eschar and effective debride the burn eschar and has no apparent digestive effect on non-burned viable dermis and normal skin. Percentage PMNs almost similar in all groups and there is no statistically different between group of intervention and the control (p=0.47).]"

"[Latar belakang: Tujuan studi ini adalah untuk menilai persepsi masyarakat terhadap hasil operasi hidung pada pasien cleft menggunakan tehnik semi-open modified Tajima. Mengingat banyak tehnik operasi yang digunakan dengan berbagai kelebihan masing – masing, kami ingin mengetahui apakah tehnik yang sederhana, mudah dikerjakan dengan morbiditas yg rendah hasilnya akan mendapatkan apresiasi yang berbeda oleh orang tua dan para profesional medis.Metode: Studi cross sectional menggunakan questionnaire dengan menilai 25 foto dari hasil operasi hidung pada pasien cleft dengan tehnik semi-open modified Tajima. Duapuluh lima orang tua dan 25 orang pelaku medis dalam hal ini residen bedah plastik akan di perlihatkan foto, dan kemudian mereka akan menilai hasil operasi tersebut dengan menggunakan VAS score, yaitu berupa tanda disepanjang garis berukuran 100 mm. Data kemudian dianalisa dengan tes Chi-square. Dan korelasi antara profesional medis dan orang tua akan dianalisa menggunakan Spearman correlation.Results: Dari penelitian didapatkan perbedaan yang significant dari persepsi orangtua mengenai hasil operasi dengan professional medis sebesar -0.38 yang berarti persepsi mereka cenderung bertolak belakang. Dan terdapat korelasi lemah antara orangtua dan medis sebesar 0. 045(lebih rendah dari 0.05).Kesimpulan: Persepsi estetik antara profesional medis dan orangtua ternyata berbeda. Dan korelasi antara persepsi yang satu dengan yang lainnya ternyata lemah. Sebagai orang terdekat dan yang bertanggung jawab terhadap pasien, memang sudah sewajarnya kita mendengarkan dan menelaah apa sebenarnya keinginan dan harapan mereka. , Background: There are many technique of cleft rhinoplasty has been used worldwide. Each of it came with their advantage and disadvantage. Technique that has been known with simple, easy and less morbidity are semi – open modified Tajima technique, but it always judged as a second class compare to the open rhinoplasty, despite the higher morbidity of the open rhinoplasty. But actually no one ever try to find if result of the semi –open rhinoplasty modified Tajima technique are really dislike by the community. Are the medical professional communities whom prefer sophisticated technique with exquisite result or the parents also share the same interest? The different perception between medical profesional and parents are the thing we like to observe. Methods: A cross sectional research on a 25 consecutive sample for each grouup. Twenty-five photograph of a patient that has been through rhinoplasty using semi – open modified Tajima technique are shown to 25 parents and 25 medical professional (plastic surgery resident). After observe the photograph, parents and residents are giving their judgment on a questionnaire using VAS score. They put a mark on a 100 mm ruler base on their judgments. After that the result was analyzed using chi square, and correlation between parents and residents are analyzed using Spearman correlation. Results: The result shown that there are 12 poor perception and 13 good perception from medical professional, while there are 13 poor perception and 12 good perception from parents. There 6 poor perceptions by both medical professional and parents, and 6 good perceptions by booth parents and medical professional. A kappa value from this research is – 0.38, which means the two observers classify Background: There are many technique of cleft rhinoplasty has been used worldwide. Each of it came with their advantage and disadvantage. Technique that has been known with simple, easy and less morbidity are semi – open modified Tajima technique, but it always judged as a second class compare to the open rhinoplasty, despite the higher morbidity of the open rhinoplasty. But actually no one ever try to find if result of the semi –open rhinoplasty modified Tajima technique are really dislike by the community. Are the medical professional communities whom prefer sophisticated technique with exquisite result or the parents also share the same interest? The different perception between medical profesional and parents are the thing we like to observe. Methods: A cross sectional research on a 25 consecutive sample for each grouup. Twenty-five photograph of a patient that has been through rhinoplasty using semi – open modified Tajima technique are shown to 25 parents and 25 medical professional (plastic surgery resident). After observe the photograph, parents and residents are giving their judgment on a questionnaire using VAS score. They put a mark on a 100 mm ruler base on their judgments. After that the result was analyzed using chi square, and correlation between parents and residents are analyzed using Spearman correlation. Results: The result shown that there are 12 poor perception and 13 good perception from medical professional, while there are 13 poor perception and 12 good perception from parents. There 6 poor perceptions by both medical professional and parents, and 6 good perceptions by booth parents and medical professional. A kappa value from this research is – 0.38, which means the two observers classify ]"

"[Latar Belakang : Luka bakar listrik berpotensi untuk menjadi penyebab terjadinya gagal multiorgan dengan angka mortalitas dan morbiditas yang tinggi. Kombinasi antara luka bakar pada kulit yang luas serta kerusakan organ dalam menyebabkan meningkatnya kebutuhan cairan akibat banyaknya cairan yang hilang. Kerusakan pada jantung dan otot dapat menyebabkan myoglobulinuria. Myoglobin menyebabkan obsruksi dan vasokontriksi serta mebyebabkan gagal ginjal. Resusitasi cairan menggunakan metode parkland dan titrasi diharapkan dapat merehidrasi, mengembalikan fungsi ginjal serta mencegah komplikasi pada ginjal akibat myoglobin pada urin. Penelitian ini bertujuan untuk mengevaluasi angka kejadian gagal ginjal pada pasien luka bakar listrik yang di resusitasi dengan formula parkland dan titrasi.Metode : Penelitian ini merupakan studi retrospektif pada pasien luka bakar listrik yang dirawat di Unit Luka Bakar RSCM Jakarta dari Januari 2010 hingga Januari 2014. Data yang dikumpulkan meliputi identitas, jumlah cairan saat resusitasi 24 jam pertama, nilai kreatinin hari pertama dan ketiga, warna urin, riwayat gagal ginjal, waktu kejadian dan kedatangan pasien ke RS dan luas luka bakar. Kami bagi menjadi dua kelompok, kelompok AKI dan non-AKI dengan menggunakan kriteria RIFLE. Dilakukan penghitungan Parkland Score pada masing-masing kelompok dan dibandingkan menggunakan analisa t-test.Hasil : Terdapat 49 pasien luka bakar listrik yang memenuhi kriteria inklusi. 36 pasien datang dengan myoglobulinuria. 64.8% (n=24) pasien tidak mengalami gagal ginjal tapi 35.1% mengalami gagal ginjal (n=13). Pada metode T Test didapatkan hasil bermakna antara penggunaan parkland score dengan angka kejadian gagal ginjal (P<0.05). variable lainnya seperti umur, waktu keterlambatan, berat badan serta luas luka bakar tidak memberikan hasil yang bermakna. Tidak adanya hubungan bermakna antara hemoglobinuria dengan kejadian gagal ginjal.kesimpulan : Resusitasi cairan yang adekuat sangat penting dalam manajeman dini luka bakar. Formula parkland sudah banyak digunakan sebagai dasar perhitungan cairan resusitasi. Terdapat hasil yang bermakna pada hubungan antara pemberian cairan menggunakan formula parland dan titrasi dengan angka kejadian gagal ginjal. Study ini membuktikan bahwa pemberian cairan berdasarkan formula parkland dan titrasi dapat menurunkan angka kejadian gagal ginjal pada luka bakar listrik. Myoglobulinuria sendiri tidak menunjukkan hubungan dengan angka kejadian gagal ginjal akut, kemungkinan disebabkan karena myoglobulinuria sendiri hanya merupakan salah satu faktor penyebab gagal gagal ginjal pada luka bakar listrik., Background: Electrical burn injury has potential cause of multisystem injury with high morbidity and mortality. The combination of extensive burns and significant internal injury in cases of severe high voltage electrical injury leads to increase fluid requirements due to fluid extravasation and ongoing fluid losses, Cardiac complication and muscle destruction that cause myoglobinuria. Myoglobin causes renal obstruction and intrarenal vasoconstriction and could result in acute kidney injury. Fluid resuscitation using parkland titration method is applied to rehidrate, restore renal function and prevent further damage caused by myoglobin. The study aimed to evaluate the incidence of Acute Kidney Injury related to the first 24 hour fluid resuscitation using the parkland formula and titration method in electrical burn injury.Method: This is a retrospective cohort design, recruited from medical records in Cipto Mangunkusumo Hospital from january 2010 to january 2014. Data will be collected at baseline and after resuscitation. Patients information included age, time of refferal, cause of burn, resuscitation fluid , urine production, urine colour, serum creatinin level at day 1-3. We divide all electrical burn injury patients into two group, AKI (Acute Kidney Injury) group and non-AKI group, using RIFLE classification. Then we compare the fluid resuscitation using Parkland score within two group. We also compare other risk factor contributing AKI in electrical burn injury including delayed time characteristic.Results: A total of 49 patiens of electrical burn injury mets the study inculsion criteria, 36 patients presented with myoglobulinuria during admission to the hospital. 64.8% (n=24) did not have AKI while 35.1% had AKI (n=13). Independent T test showed significant differences between parkland score and the occurence of Acute Kidney Injury (P < 0,05). Other variables such as age, delayed time, weight and percentage of burn did not show any significant differences related to acute kidney injury. The presence of hemoglobinuria supposed to increase the number of acute kidney injury but in contrary it did not have significance result related to acute kidney injury (P>0.05).Conclusions: Adequate resuscitation is essential in a succesful early burn management.. Parkland formula had been used widely as guidelines for fluid resuscitation. There is a significant result relating th use of parkland formula with titration and acute kidney injury. This study confimed that administering resuscitation fluid according to the parkland formula and maintaning the hidration using titration method could decreased the number of acute kidney injury. Clearly, Myoglobinurea alone can not be held accountable as predictor of an acute kidney injury, it is only one of several causes of acute kidney injury.]"

"[Pendahuluan. Sebelum berhadapan dengan pasien yang nyata, seorang ahli bedah plastik pemula berupaya meningkatkan ketrampilan dengan berlatih pada model. Penelitian ini mengimplementasikan metode pelatihan berbasis wet-lab menggunakan perfusi ke a.femoralis ayam untuk mengevaluasi peningkatan keterampilan mikro.Metode. Dua puluh satu residen bedah plastik (wanita n = 14 (66,7%) dan laki-laki n = 7 (33%)) tanpa pengalaman mikro sebelumnya direkrut dalam penelitian ini. Menjalani serangkaian pelatihan, yang terdiri dari satu sesi kognitif dan lima sesi berbasis keterampilan melakukan anastomosis término-terminal arteri femoralis ayam dengan diameter 2 mm. Pre dan post test dinilai menggunakan University of Western Ontario Microsurgical Assessment (UWOMSA). Sesi keterampilan yang direkam pada video, dan dinilai oleh konsultan mikro sebagai evaluator tunggal. Penelitian ini terbatas untuk arteri end-to-end anastomosis. Hasil. Dari total 42 video termasuk 21 modul simpul-mengikat dan 21 modul anastomosis. Median pre-test skor UWOMSA adalah 23 tapi tidak ada subjek yang berhasil mencapai skor maksimal 30. Skor median post-test adalah 27,5 (hampir 5 poin perbaikan, P = 0,0) dan 2 subyek mencapai skor 30. Nilai rata-rata waktu yang dihabiskan untuk menyelesaikan prosedur anastomosis juga lebih cepat dari 41,86 menjadi 34,14 menit (P = 0,01).Kesimpulan. Menerapkan pelatihan yang diusulkan akan meningkatkan keterampilan pemasangan anastomosis., Background. Before entering real clinical setting, a novice plastic surgeon will benefit from repetitive training on non-living models. This study implements the bench-top training method using perfused chicken thigh model to evaluate improvement in microsurgical skills.Methods. Twenty-one plastic surgery residents (women n=14 (66.7%) and men n=7 (33%)) with no prior microsurgical experience were recruited in this study. They underwent a set of training, consisting of one cognitive session and five skill-based sessions performing the end-to-end anastomosis using chicken femoral artery with a diameter of 2 mm. They were assessed using the University of Western Ontario Microsurgical Skills Assessment (UWOMSA) scoring system at the first skill session and re-evaluated at the fifth skill session. The skill sessions are recorded on video, blinded, and assessed by a consultant microsurgery as a single evaluator. The study was limited to arterial end-to-end anastomosis.Results. Forty-two videos were reviewed, including 21 knot-tying sessions and 21 anastomoses. The median pre-test UWOMSA score was 23 but none of the subjects managed to reach the maximal score of 30. The median post-test results were 27.5 (almost 5 points improvement, P=0.0) and 2 subjects achieved a score of 30. The average time spent to accomplish the full anastomosis procedure was also reduced from 41.86 to 34.14 minutes (P=0.01).Conclusion. Using the proposed training skill-based session will improve the subject’s microvascular anastomosis skill.]"

"[Pendahuluan:Fraktur yang mengenai midface akan menyebabkan gangguan fungsi baik fungsi mata maupun oklusi. Walaupun angka kejadian fraktur midface cukup tinggi, terdapat gangguan fungsional, dan membutuhkan biaya yang besar untuk tatalaksana menggunakan mini plate dan screw, tidak ada informasi mengenai hasil fungsional setelah tatalaksana fraktur midface.Metode:Data mengenai status fungsional pasien dengan fraktur midface sebelum operasi ORIF didapatkan dari data rekam medis dan data setelah operasi ORIF didapatkan dari pemeriksaan objektif dan subjektif. Status fungsional meliputi diplopia, gerakan bola mata, maloklusi, dan gangguan nervus fasialis dan nervus infraorbita.Hasil:Semua pasien yang dievaluasi menunjukkan perbaikan status fungsional setelah operasi ORIF.Kesimpulan:Pasien dengan fraktur midface yang telah menjalani operasi ORIF di Divisi Bedah Plastik Rumah Sakit Cipto Mangunkusumo menunjukkan adanya perbaikan pada diplopia, gerakan bola mata, oklusi, dan fungsi nervus fasialis dan infraorbita pada evaluasi jangka panjang.;Background:Fractures involving the midface present more challenges due to the impairment on function both occlusion and visual function. In spite of the high number of occurrence, high impact to the impairment on function, and high cost in the treatment due to relatively expensive hardware required (mini plate and screw), there is inadequate information about the outcome after treating midface fracture.Methods:Data on functional status of patients with midface fracture before ORIF surgery collected from medical records and data after ORIF surgery gathered objectively and subjectively. Functional status including diplopia, eye motility, cranial facial nerve impairment, infraorbita nerve impairment and malocclusion.Results:All of the patients that have been evaluated was showing improvement in total functional status after treatment with ORIF surgery.Conclusion:Midface fracture patients underwent ORIF surgery in Plastic Surgery Division, Cipto Mangunkusumo hospital, resulted in the recovery of eye motility function, diplopia, malocclusion and facial and infraorbital nerve impairment at longterm evaluation., Background:Fractures involving the midface present more challenges due to the impairment on function both occlusion and visual function. In spite of the high number of occurrence, high impact to the impairment on function, and high cost in the treatment due to relatively expensive hardware required (mini plate and screw), there is inadequate information about the outcome after treating midface fracture.Methods:Data on functional status of patients with midface fracture before ORIF surgery collected from medical records and data after ORIF surgery gathered objectively and subjectively. Functional status including diplopia, eye motility, cranial facial nerve impairment, infraorbita nerve impairment and malocclusion.Results:All of the patients that have been evaluated was showing improvement in total functional status after treatment with ORIF surgery.Conclusion:Midface fracture patients underwent ORIF surgery in Plastic Surgery Division, Cipto Mangunkusumo hospital, resulted in the recovery of eye motility function, diplopia, malocclusion and facial and infraorbital nerve impairment at longterm evaluation.]"

"Latar Belakang. Tujuan dari operasi bibir sumbing adalah untuk memperbaiki celah bibir/ sumbing bibir dengan mencapai hasil yang baik yaitu bentuk bibir yang simetris kiri - kanan dan juga kualitas parut yang halus, dengan alasan tersebut maka keberhasilan operasi tidak hanya bergantung pada kemampuan teknik operasi yang baik dan peralatan serta benang yang digunakan dalam operasi tersebut melainkan juga perawatan luka pascaoperasi yang sangat berpengaruh terhadap kualitas .Perawatan luka pascaoperasi dilakukan oleh pengasuh anak yaitu ibu kandung yang memiliki peran penting dalam proses perawatan luka pascaoperasi. Pengetahuan ibu tentang tata cara perawatan luka dan status kejiwaan ibu memiliki hubungan yang tidak dapat dipisahkan. Pada studi ini kami akan mencari hubungan diantara keduanya yaitu status kejiwaan ibu dan kualitas dari perawatan luka/ parut pascaoperasi bibir sumbing.Bahan dan MetodeStudi ini adalah studi potong lintang, dilakukakn di Rumah Sakit Cipto Mangunkusumo pada periode Januari ? Desember 2014 dengan partisipasi dari ibu yang memiliki anak bibir sumbing yang secara sukarela menyetujui untuk dilakukan tindakan operasi bibir sumbing pada anak mereka yang dibuktikan dengan menandatangani lembar persetujuan. Partisipan diwawancarai dan mengisi kuisioner Self Reporting Quistionnaire-20 (SRQ-20) dan Mini International Neuropsychiatric Interview Versi on International Classification of Disease X ( M.I.N.I ICD X) yang diterbitkan oleh Organisasi Kesehatan Dunia sebagai uji diagnosti untuk gangguan jiwa. Pemeriksaan pada ibu dilakukan sebelum operasi pada penderita bibir. Pada studi ini kami menggunakan The Stony Brook Scar Evaluation Scale sebagai nilai ukur terhadap kualitas parut.HasilDidapatkan 5 orang ibu yang terdiagnosa menderita gangguan jiwa berdasarkan pemeriksaan dengan menggunakan Self Reporting Questioneer - 20 yang menjawab pertanyaan dengan jawaban "ya" yang mempunyai nilai lebih dari 5, dan kami melakukan pemeriksaan lebih lanjut dengan menggunakan M.I.N.I ICD X untuk mengetahui jenis dari gangguan jiwa tersebut yang dilakukan 2 bulan pascaoperasi didapatkan hasil bahwa seluruh ibu yang awalnya terdiagnosa menderita gangguan jiwa dianggap sehat dan seluruh gejala klinis sebagai gangguan jiwa telah menghilang. Kualitas parut dari 22 operasi bibir sumbing didapatkan hasil 6 anak dengan parut yang memiliki kualitas kurang baik dengan nilai The Stony Brook Scar Evaluation Scale kurang dari 5 ( nilai 3 sebanyak 5 orang anak dan 1 orang anak memiliki nilai 4 ). Data dianalisa dengan menggunakan SPSS dan diuji dengan menggunakan Chi Square test ( Fisher's exact Test ), tidak terdapat hubungan yang signifikan antara kondisi kesehatan jiwa ibu dengan kualitas perawatan parut pascaoperasi bibir sumbing (Exact sig 1.00).

---

Background

The aim of cheiloplasty is correcting of cleft lip with the good quality to achieve symmetrical on left and right side and also with the finest scar. Hence those reason not only depend on excellent surgery procedural skill and materrial used by surgeon but also caring of wound after surgery which most influential the healing of scar. Postoperative wound care by mother as a caregiver. Mother participation as a caregiver for caring the wound is the most important thing. Mother knowledge of wound care and mental health of mother are both closely relationship. This study, we are looking for Relation between mental health of Mother and quality caring of scar after cheiloplasty.

Material and Methods

The study is cross sectional, in Cipto Mangunkusumo Hospital since on January - December 2014 with participant all of mother who agree her children to perfome cheiloplasty after informed consent. The participant Interviewed and quistionnaired by Self Reporting Quistionnaire-20 (SRQ-20) and of Mini International Neuropsychiatric Interview Versi on International Classification of Disease X ( M.I.N.I ICD X) by World Health Organization for diagnostic of mental health disorder on mother before perfome cheiloplasty. We use The Stony Brook Scar Evaluation Scale as parameter of scar quality.

Result

There are 5 mother's mental health disorder according examinated by Self Requesting Questioneer - 20 who answered "yes" above 5 point, and we perfomed advanced examination using M.I.N.I ICD X to knowing dygnoses of mental health disorder. Mother advaced examination perfomed over 2 month after cheiloplasty on children, and the result are all of clinical sign of mother disorder were disappeared. Quality of caring scar from 22 cheiloplasty, only 6 scar categorised not god below 5 point of The Stony Brook Scar Evaluation Scale (3 point 5 children and 4 point 1 child). Data Analysed by SPSS and tested by Chi Square test (Fisher's exact Test), there is no significance relationship between Mother?s mental health and Quality of caring scar after cheiloplasty (Exact sig 1.00)."