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Abstrak :
ABSTRAK
Hubungan Ketidaktepatan Pemberian Antibiotika Profilaksis denganKejadian Infeksi Daerah Operasi Post Laparatomi di RSPADGatot Soebroto Tahun 2014-2017Pembimbing : dr. Asri C. Adisasmita MPH., M.Phil., Ph.DInfeksi Daerah Operasi IDO termasuk salah satu dari Healthcare AssociatedInfection rsquo;s HAI 39;s yang paling banyak ditemukan seiring dengan meningkatnya jumlahtindakan operasi. Laparatomi merupakan jenis tindakan operasi yang paling berisikountuk terjadinya infeksi. Salah satu upaya pencegahan infeksi daerah operasi denganpemberian antibiotika profilaksis yang diberikan sebelum, saat dan sampai 24 jam setelahoperasi pada kasus yang secara klinis tidak didapatkan tanda-tanda infeksi. Penelitian inibertujuan untuk mengetahui hubungan ketidaktepatan pemberian antibiotika profilaksisdengan kejadian infeksi daerah operasi post laparatomi di RSPAD Gatot Soebroto Tahun2014-2017. Desain penelitian menggunakan studi kasus kontrol dengan pengambilan datasecara retrospektif menggunakan 268 sampel dari data rekam medik pasien post operasilaparatomi di RSPAD Gatot Soebroto pada tahun 2014-2017, kasus yaitu 67 pasien yangterjadi IDO dan kontrol 201 pasien tidak terjadi IDO . Analisa data dengan uji regresilogistik dengan conditional matching. Hasil penelitian menunjukkan waktu pemberianantibiotika profilaksis pre operasi tidak tepat memiliki risiko 5.17 kali terhadap kejadianinfeksi daerah operasi OR= 5.17 ; 95 CI=1.85-14.40 setelah dikontrol dengan variabellain. Variabel kovariat yang berhubungan terhadap kejadian infeksi daerah operasi yaitudiagnosis operasi digestif OR=3.51; 95 CI=1.04-11.83 , kadar albumin OR= 3.83;95 CI= 1.30-11.25 dan penyakit penyerta OR = 4.05 ; 95 CI=1.40-11.66 . Hasilpenelitian ini dapat menjadi masukan bagi RSPAD Gatot Soebroto untuk lebihmeningkatkan kepatuhan penggunaan antibiotika profilaksis secara tepat waktu, jenis,dosis dan durasi pemberian sesuai panduan untuk mencegah kejadian infeksi daerahoperasi.Kata Kunci: Antibiotika Profilaksis, Infeksi daerah operasi, Laparatomi.

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ABSTRACT
Correlation of Inappropriate Antibiotic Prophylaxis with PostLaparatomy Surgical Site Infection at Gatot Soebroto Army CentralHospital Year 2014 to 2017Counsellor dr. Asri C. Adisasmita MPH., MPhil., Ph.DSurgical Site Infection SSI is one of the most commonly infection foundHealthcare Associated Infection 39 s HAI 39 s type as surgery procedure increases.Laparotomy is the type of surgery that is the most at risk for infection. One of theprevention efforts of surgical site infection is antibiotic prophylaxis administrationbefore, during and up to 24 hours after surgery in cases of clinically missing signs ofinfection. This study aims to determine the correlation of inappropriate antibioticsprophylaxis with the post laparatomy surgical site infection in Army Central Hospital RSPAD Gatot Soebroto from 2014 to 2017. The research design was case controlstudy with retrospective data retrieval, using 268 samples from medical record data ofpost laparotomy patient at Army Central Hospital RSPAD Gatot Soebroto from 2014to 2017, cases of 67 patients with SSI and control of 201 patients without SSI . Datawas analyzed using regression logistic conditional matching test. The result of thestudy showed that the inappropriate timing of antibiotic administration in preoperativetreatment made a risk of 5.17 times higher on the incidence of surgical site infection OR 5.17 95 CI 1.85 14.40 after control of other variables. Covariate variables,related to the incidence of surgical site infection, was digestive operation diagnose OR 3.51 95 CI 1.04 11.83 , albumin level OR 3.83 95 CI 1.30 11.25 and comorbid disease OR 4.05 95 CI 1.40 11.66 . The results of this studyhopefully can be an input data for Army Central Hospital RSPAD Gatot Soebroto,to improve adherence of correct timing, type, dose and duration of antibioticsprophylaxis according to guidelines of surgical site infection prevention.Key words Antibiotic Prophylaxis, Surgical Site Infection, Laparatomy

Abstrak :
Surgical site infections are the second most frequent nosocomial infection after catheter infection. They are associated with increase morbidity and mortality, iength of stay in hospital and cost of care. Antibiotic prophylaxis use is addressed to reduce incidence of surgical site infection. The aim of this research was to find out the pattern of antibiotic prophylaxis use; incidence of surgical site infection; association between antibiotic prophylaxis use and incidence of surgical site infection; and other factors that influence the incidence of surgical site infection. This research was carried out in Dr. Cipto Mangunkusumo Hospital Jakarta and it was a retrospective study with cross-sectional design. A total of 220 samples had been taken proportional randomly according to the type of surgery division from 1,841 medical records in 2005. The result showed that the most antibiotic prophylaxis frequently used was cephalosporin (first and third generation). followed by phosphomycin and metronidazole. Most of the patients were given antibiotic prophylaxis in inappropriate time and the duration of use was more than one day. This study found that the incidence of surgical site infection was 8.6% with the highest percentage occurred at orthopedic surgery (23.3%). Statistically, there was no relationship of class. Timing and duration of antibiotic prophylaxis use with incidence of surgical site infection. Adherence of antibiotic prophylaxis use to hospital guideline was not influenced the incidence of surgical site infection. Multivariate analysis with logistic regression analysis showed that the incidence of surgical site infection were influenced by the type of surgery (OR=2.6) and the use of antibiotics during hospitalization prior to surgery (OR=3.2). The conclusion of this research were the incidence of surgical site infection relatively high and class. timing, duration and adherence to hospital guideline of antibiotic prophylaxis use did not influence it. The wound contaminated and the use antibiotics during hospitalization prior to surgery were risk factors for surgical site infection. It was recommended that the hospital management revise the currently used surgical antibiotic prophylaxis guideline which is no longer relevant to the current situation.

Abstrak :
Latar belakang : Pembedahan abdomen secara laparotomi menyebabkan penurunan kadar albumin. Kadar albumin di bawah 3,00 g/dL berperan dalam terjadinya mortalitas dan morbiditas pasca-operasi. Tujuan: Mengetahui hubungan antara kadar albumin pre-operasi dan pasca-operasi terhadap luaran klinis pasca-operasi laparotomi. Metode : Penelitian ini dengan desain kohort retrospektif menggunakan data rekam medis Departemen Ilmu Kesehatan Anak tahun 2015-2017. Total sampling pada pasien pasca-laparotomi di PICU dengan rentang usia 1 bulan hingga 18 tahun, dikelompokan ke dalam dua kategori, yaitu: albumin ≤ 3,0 g/dL dan > 3,00 g/dL. Subyek diambil data luaran klinis pasca-operasi seperti sepsis pasca-operasi, infeksi luka operasi, dehisens, relaparotomi, dan lama rawat di PICU. Hasil : Dua ratus satu subyek pasca-laparotomi diikutsertakan dalam penelitian ini. Kadar albumin pre-operasi ≤ 3,0 g/dL meningkatkan risiko terjadinya sepsis pasca-operasi (RR 3,40(95%IK: 1,54-7,51), relaparotomi (RR 3,84(95%IK: 1,28-11,49), dan lama rawat PICU 2 kali lebih lama daripada normoalbuminemia. Kadar albumin pasca-operasi ≤ 3,0 g/dL meningkatkan risiko terjadinya sepsis pasca-operasi (RR 2,55(95%IK: 1,40-4,63) dan lama rawat PICU 1 hari lebih lama daripada normoalbuminemia. Mortalitas pada kelompok hipoalbuminemia sebesar 19,2% dengan RR 3,44(95%IK: 1,07-11,07). Simpulan : Hipoalbuminemia pre-operatif atau pasca-operatif meningkatkan risiko kejadian sepsis pasca-operatif. Hipoalbuminemia pre-operatif atau pasca-operatif tidak berhubungan dengan infeksi luka operasi. Hipoalbuminemia pre-operatif atau pasca-operatif tidak berhubungan dengan risiko kejadian dehisens. Hipoalbuminemia pre-operatif meningkatkan risiko untuk menjalani relaparotomi. Hipoalbuminemia pre-operatif atau pasca-operatif memperpanjang lama rawat di PICU. Hipoalbuminemia pre-operatif meningkatkan angka mortalitas. ...... Backgrounds : Laparotomy abdominal surgery decreasing serum albumin. Serum albumin concentration below 3,00 g/dL associated with postoperative morbidity and mortality. Aim: To determine the relationship between serum albumin (preoperative and postoperative) and postoperative clinical course. Methods : Retrospesctive observational study in pediatric patients undergoing laparotomy and hospitalized in Pediatric Intensive Care Unit during January 2015- December 2017. Post-laparotomy patients over the age range 1 month to 18 years, classified according to serum albumin concentration: ≤ 3,0 g/dL and > 3,00 g/dL. Postoperative outcome measured by postoperative sepsis, surgical site infection, dehiscence, relaparotomy, PICU length of stay, and mortality. Results : Two hundred and one subjects undergone laparotomy participated. Preoperative serum albumin ≤ 3,0 g/dL increase risk of postoperative sepsis (RR 3,40 (95%CI: 1,54-7,51)), relaparotomy (RR 3,84 (95%CI: 1,28-11,49)), and twice longer in Pediatric Intensive Care Unit length of stay. Postoperative albumin ≤ 3,0 g/dL increase risk of postoperative sepsis (RR 2,55(95%CI: 1,40-4,63)) and Pediatric Intensive Care Unit length of stay. Mortality rate in hypoalbuminemic group is 19,2% with RR 3,44(95%CI: 1,07-11,07). Conclusions : Preoperative and postoperative hypoalbuminemia increase risk of postoperative sepsis. Preoperative and postoperative hypoalbuminemia not associated with risk of surgical site infection and wound dehiscense. Preoperative hypoalbuminemia increase risk of relaparotomy. Preoperative and postoperative albumin concentration inversely related with Pediatric Intensive Care Unit length of stay. Preoperative hypoalbuminemia increase mortality rate.

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Seksio Sesaria merupakan prosedur rutin yang sering dilakukan di bidang obstetri. Tingginya angka seksio sesaria di RSAU dr. Esnawan Antariksa (80%) dibandingkan dengan tandar WHO (15%), dapat berdampak terhadap luaran pasien, khususnya meningkatkan peluang terjadinya infeksi dan lama rawat. Tujuan penelitian ini adalah mencari hubungan kelengkapan pengisian Surical Safety Checklist (SSC) pada seksio sesaria terhadap Infeksi Luka Operasi (ILO) pasca seksio sesaria. Karakterisik demografis dan klinik diperoleh dari rekam medis. Pasien yang dilakukan seksio sesaria diikuti sampai 30 hari dan ditelusuri terjadinya ILO. Desain penelitian ini berupa kuantitatif kohort retrospektif, hubungan dianalisis dengan regresi logistik. Ditemukan bahwa kejadian ILO pasca SC sebesar 3,2% (31 pasien). Kelengkapan pengisian SSC mayoritas sudah lengkap (n=978). Kelengkapan pengisian SSC fase sign in, time out dan sign out yaitu 92,1%, 82,2% dan 92,4%. Tidak terdapat hubungan antara kelengkapan pengisian SSC fase sign in dan time out dengan ILO pasca seksio sesaria serta terdapat hubungan berlawanan arah yang signifikan secara statistik antara kelengkapan SSC fase sign out, dengan ILO (P=0,026). Kesimpulannya mayoritas kelengkapan pengisian SSC di RSAU dr. Esnawan Antariksa sudah lengkap, ada hubungan berlawanan arah antara kelengkapan pengisian SSC fase sign out pada seksio sesaria dengan ILO di RSAU dr. Esnawan Antariksa. ......Caesarean section is an routine obstetrics procedure. Number of cesarean sections at RSAU dr. Esnawan Antariksa (80%) was higher than WHO standard (15%).That phenomena impact to patient outcomes, particularly increasing the probability of infection and length of stay. The purpose of This study purposes to find correlation between the completeness of the Surical Safety Checklist (SSC) and surgical site infection (SSI) after cesarean section. Patients who underwent cesarean section were followed up for 30 days and traced SSI. This was retrospective quantitative cohort study. We found SSI prevalence was 3.2% (31 patients). The majority of SSC completion were complete (n=978). The completeness of filling in SSC phases of sign in, time out and sign out are 92.1%, 82.2% and 92.4%. There was no association between the completeness of the SSC filling in the sign-in and time-out phases with SSI following cesarean section and there was a statistically significant opposite correlation between the completeness of the SSC in the sign-out phase and SSI (P=0.026). In conclusion, although the majority of the completeness of SSC filling in RSAU dr. Esnawan Antariksa was complete, and there was opposite association between the completeness of filling out the SSC in the sign out phase, SSC recommended used as maintenance patient safety quality standar.

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ABSTRACT
Purpose: The development of surgical site infection (SSI) after biliary reconstruction is highly influenced by the presence of preoperative bacteria in the bile juice. We selected vancomycin and piperacillin/tazobactam (VCM + PIPC/TAZ) as perioperative prophylactic antibiotics for patients undergoing pancreaticoduodenectomy. This study aimed to retrospectively analyze the effectiveness of VCM + PIPC/TAZ compared to cefmetazole. Methods: Seventy-two patients who underwent pancreaticoduodenectomy between April 2015 and March 2017 at our department were evaluated. Forty patients were administered cefmetazole as the perioperative prophylactic antibiotic, and 32 were administered VCM + PIPC/TAZ. The intraoperative VCM blood concentration (incision, biliary reconstruction, and wound closure) was measured during surgery to confirm the hemodynamics. Results: The frequency of SSIs was significantly lower in the VCM + PIPC/TAZ group (8/32 patients) than in the cefmetazole group (20/40 patients, P = 0.031). Postoperatively, significantly fewer patients in the VCM + PIPC/TAZ group (4/32 patients) required ≥ 15 days of additional antibiotic administration compared to those in the cefmetazole group (14/40 patients, P = 0.033). Six of 32 patients in the VCM + PIPC/TAZ group showed redneck syndrome symptoms. There was no significant difference in the VCM blood concentration between patients with and without SSIs. Conclusions: The use of VCM + PIPC/TAZ can reduce the incidence of SSI after pancreaticoduodenectomy and also reduce the need for the additional administration of antibiotics for ≥ 15 days after surgery.

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Malnutrisi sering ditemukan pada anak dengan pasca pembedahan dan berhubungan dengan luaran sepsis atau infeksi luka operasi. Penelitian observasional analitik ini bertujuan mengetahui pengaruh malnutrisi terhadap luaran pasien pasca pembedahan dengan mengukur penurunan kadar RBP pada hari pertama dan kelima pasca pembedahan. Dilakukan pengukuran kadar RBP, kortisol, CRP pada hari pertama dan kelima pasca pembedahan, luaran infeksi dinilai berdasarkan skor ASEPSIS. Hasil penelitiaan ini menunjukkan penurunan RBP, peningkatan CRP, usia dan skor ASA berturut-turut memberikan risiko 4,4;3,3;1,2 dan 1,3 kali terjadinya infeksi luka operasi pada pasien pasca pembedahan mayor, namun tidak didapatkan perbedaan yang bermakna. ......Malnutrition is often found in children with post-surgery and associated with poor outcomes such as sepsis or surgical wound infections. This analytic observational study aims to determine the effects of malnutrition on the outcomes of patients after surgery by measuring the decrease in Retinol Binding Protein (RBP) levels on the first and fifth day post-surgery. We measured levels of RBP, cortisol, CRP in the first and fifth day post-surgery and infection outcomes were evaluated according to ASEPSIS score. The results of this study showed a decrease in RBP, an increase in CRP, age and ASA score consecutively provide risk 4.4; 3.3, 1.2 and 1.3 times for occurrence of surgical wound infections in patients after major surgery, but there were no statistically differences.

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ABSTRAK Laringektomi total merupakan prosedur yang umum dilakukan pada karsinoma sel skuamosa laring. Infeksi luka operasi merupakan salah satu komplikasi yang sering dan dapat memberikan dampak yang besar terhadap kualitas hidup pasien. Penggunaan antibiotika profilaksis merupakan salah satu cara pencegahan ILO namun belum ada literatur pasti yang menyebutkan penggunaan antibiotika profilaksis pada laringektomi total sebaiknya digunakan selama berapa lama. Penelitian ini merupakan suatu studi eksperimental kuasi dengan kontrol yang diambil secara retrospektif untuk melihat kejadian infeksi pasca operatif pada penggunaan Sefazolin sebagai antibiotika profilaksis perioperatif selama 5 hari pada kelompok eksperimen dibandingkan dengan kelompok kontrol statik dari data retrospektif yang menggunakan Sefazolin 30 menit sebelum insisi dan diteruskan dengan antibiotika yang berbeda selama lebih dari 12 hari di Divisi Laring Faring Departemen THT-KL FKUI-RSCM. Tiga dari 12 subyek mengalami infeksi pada kelompok eksperimen dan 2 dari 24 subyek mengalami infeksi pada kelompok kontrol. Tidak terdapat perbedaan yang bermakna proporsi angka kejadian ILO pada kedua kelompok. Analisis univariat dan bivariat dilakukan untuk menilai beberapa faktor risiko dan studi ini menunjukkan adanya hubungan yang bermakna antara penyakit ginjal dan penyakit komorbid >1 dengan angka kejadian ILO.

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ABSTRACT Total laryngectomy is a common procedure in laryngeal squamous cell carcinoma. Surgical site infection is one frequent complication and it can have a major impact on patient rsquo s quality of life. The use of prophylactic antibiotics is one of the prevention of surgical site infections but there is no definite literature mentioning the use and how long should the prophylactic antibiotics be used in total laryngectomy. This study was a quasi experimental study with retrospective controls to look at the incidence of postoperative infection on the use of Cefazolin as the perioperative prophylactic antibiotics for 5 days on the experimental group compared to the static control group from retrospective data using Cefazolin 30 minutes before incisions and continued with different antibiotics for more than 12 days in Larynx Pharynx Division of ORL HNS Department of Medical Faculty of Universitas Indonesia. Three of 12 subjects had an infection in the experimental group and 2 of 24 subjects had an infection in the control group. There was no significant difference in the proportion of incidence of surgical site infections in both groups. Univariate and bivariate analyzes were performed to assess several risk factors and this study showed a significant association between renal disease and comorbid disease 1 with the incidence rate of surgical site infections.

Abstrak :
Penggunaan antibiotik secara benar telah menjadi perhatian dunia medis dikarenakan meningkatnya kejadian resistensi antibiotik. Prosedur standar penggunaan antibiotik profilaksis telah banyak diterapkan dalam prosedur bedah urologi, namun penggunaan obat antibiotik secara berkepanjangan setelah prosedur bedah urologi belum banyak dipelajari, terutama pada tindakan bedah urologi dengan kriteria bedah tercemar sepertilaparoscopy living donor nephrectomy(LLDN). Penelitian ini bertujuan untuk mengevaluasi aspek efisiensi dan keaman dari penggunaan antibiotik profilaksis dosis tunggal pada tindakan pembedahan LLDN di Rumah Sakit Cipto Mangunkusumo, Jakarta. Penelitian in merupakan studi klinis acak tersamar ganda yang dilakukan pada April 2015 hingga Agustus 2015 di Rumah Sakit Cipto Mangunkusumo. Lima puluh pasien  pada penelitian ini dibagi menjadi 2 kelompok, dimana kelompok penelitian pertama dibagi mendapatkan 1 g cefoperazone dosis tunggal sebagai antibiotik profilaksis, sedangkan pada kelompok kedua diberikan 1g cefoperazone dosis tunggal yang kemudian dilanjutkan dengan dosis 2 kali sehari selama 3 hari. Angka kejadian infeksi pasca operasi dan faktor yang mempengaruhinya dibandingkan antara kedua kelompok percobaan. Hasil penelitian ini mendapatkan bahwa tidak ada perbedaan yang bermakna pada variabel umur, jenis kelamin, body mass index, jumlah leukosit dan hemoglobin pre operatif, durasi operasi, jumlah perdarahan intraoperatif maupun durasi perawatan pasien di rumah sakit antara kedua kelompok percobaan ini. Pada pengamatan hari pertama pasca operasi, pada kedua kelompok percobaan terdapat peningkatan jumlah leukosit: 15.540/ml (9.660/mL – 22.450/mL) pada kelompok dosis tunggal, dan 16.110/mL (9.440 /mL - 21.770/mL) pada kelompok dengan pemberian antibiotik selama 3 hari (P=0,466, 95% CI -2.453 to 1.141). Pada kelompok pasien dengan pemberian antibiotik profilaksis saja, didapatkan 1 pasien (4%) dengan gejala infeksi sistemik, sedangkan pada kelompok penelitian lainnya tidak didapatkan kejadian ini (P= 0,312). Dari penelitian ini kami menyimpulkan bahwa penggunaan antiobiotik dosis tunggal sebagai terapi profilaksis pada LLDN merupakan terapi yang aman dan efektif. ......Proper antibiotic use has been on the world concern due to the increase ofantibiotic resistant. Standardized techniques and prophylactic antibiotics are widely used in urologic surgeries, but the prolonged administration of antibiotic after an operation has not been fully studied, especially clean contaminated surgery such as laparoscopy living donor nephrectomy (LLDN). This study was aimed to evaluate efficacy and safety of single dose prophilaxis antibiotic in laparoscopic live donor nephrectomy operation in Cipto Mangunkusumo Hospital, Jakarta. This study was a double blind randomized controlled trial conductedfrom April 2015 to August 2015 in Cipto Mangunkusumo Hospital. The single dose group were given 1 g cefoperazone as prophylactic antibiotics while the 3 days group were also given cefoperazone before surgery and continued twice daily for three days. The incidence of post-operative infection and contributing factor were compared between the two groups. Fifty patients participated in our study divided equally into two groups. There was no participant failed to comprehend to the study, counted as drop out. There were no significant differences in age, gender, body mass index, pre-operative leucocyte and hemoglobin value, duration of surgery, intraoperative bleeding and length of stay between the two groups. At the follow up 1^stday after surgery both groups showed elevated level of leucocyte, 15.540/ml (9.660/mL – 22.450/mL) in the single dose group and 16.110/mL (9.440 /mL – 21.770/mL) in the 3 days group. (P=0,466, 95% CI -2.453 to 1.141). There was only 1 patient in the single dose prophylaxis group (4%) with systemic infection sign, compared to no patient in the other group (P= 0,312). Single-dose prophylactic antibiotic is safe and as effective in the management oflaparoscopic living donor nephrectomy.

Abstrak :
Latar belakang: Operasi sesar merupakan salah satu tindakan yang paling sering dilakukan dibidang obstetrik bahkan hingga dalam satu rumah sakit. Angka kejadian infeksi daerah operasi sesar sangat bervariasi pada seluruh dunia berkisar pada 3-15%. Proses terjadinya IDO merupakan suatu proses multifaktorial yang meliputi mulai dari persiapan perioperatif, kondisi pasien, jenis operasi, jenis kuman dan lain-lain. Tujuan: Mengetahui karakteristik pasien, pola kuman, dan faktor risiko kejadian infeksi daerah operasi (IDO) di RSCM tahun 2016-2018. Metode: Penelitian ini merupakan penelitian observasional dengan metode cohort retrospective. Subyek penelitian ini merupakan pasien yang menjalani operasi sesar di RSCM pada tahun 2016-2018 yang direkrut menggunakan metode consecutive sampling. Dari data yang didapatkan dilakukan analisis bivariat dan multivariat untuk menentukan faktor risiko terjadinya IDO pasca operasi sesar Hasil: Didapatkan sebanyak 2.052 kasus yang memenuhi kriteria inklusi penelitian. Sebanyak 85 kasus infeksi daerah operasi (IDO) didapatkan dari 2.052 tindakan yang dilakukan (4,14%). Sebanyak 85 kelompok kasus IDO dan 1.967 kelompok kasus kontrol diikutsertakan dalam analisis faktor risiko. Kuman paling sering didapatkan pada kultur kasus infeksi daerah operasi pasca operasi sesar adalah Staphylococcus aureus (16,5%), Klebsiella pneumoniae (12,9%), Escherischia coli (9,4%), Enterococcus faecalis (9,4%), dan lainnya (21,2%). Variabel yang berpengaruh terhadap kejadian IDO pasca secar adalah gawat janin (p=0,002 ;AOR = 2,265 IK95 % 1,350-3,801) dan IMT ≥30 kg/m2 (p=0,028; AOR 1,824 IK95% 1,066-3,121). Kesimpulan: Faktor yang berpengaruh terhadap kejadian IDO pasca SC adalah gawat janin (p=0,002 ;AOR = 2,265 IK95 % 1,350-3,801) dan IMT ≥30 kg/m2 (p=0,028; AOR 1,824 IK95% 1,066-3,121).

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Background: Caesarean section is one of the most performed operations in the field of obstetrics and even in hospital. The incidence of infections in cesarean section varies greatly around the world at 3-15%. Surgical site infection is a multifactorial process that starts from the perioperative preparation, the patient, the type of surgery, the type of germ and other factors. Objective: To determine the characteristics of patients, bacterial patterns, and risk factors for the incidence of surgical site infection (SSI) in Cipto Mangunkusumo National General Hospital in 2016-2018. Method: This study was an observational study using a retrospective cohort method. The subject of this study were patients undergoing cesarean section in Cipto Mangunkusumo National General Hospital in 2016-2018 recruited using consecutive sampling method. Based on the data obtained, bivariate and multivariate analysis were conducted to determine the factors affecting after caesarean section SSI Result: A total of 2.052 subjects were included in the study. There were 85 cases of surgical site infection (SSI) out of 2.052 operations (4.14 %). A total of 85 SSI case groups and 1.967 control groups were included in the risk factor analysis. Bacteria most commonly found in surgical site infection culture were Staphylococcus aureus (16,5%), Klebsiella pneumoniae (12,9%), Escherischia coli (9,4%), Enterococcus faecalis (9,4%), and others (21,2%). Variable associated with SSI in this study is fetal distress (p=0,002 ;AOR = 2,265 CI 95 % 1,350-3,801) and BMI ≥30 kg/m2 (p=0,028; AOR 1,824 CI 95% 1,066-3,121). Conclusion: Factors influencing the incidence of SSI after SC was fetal distress (p=0,002 ;AOR = 2,265 CI 95 % 1,350-3,801) and BMI ≥30 kg/m2 (p=0,028; AOR 1,824 CI 95% 1,066-3,121).

Abstrak :
ABSTRAK
Pendahuluan Intussusepsi merupakan kegawatdaruratan yang sering terjadi pada anak di bawah dua tahun dengan salah satu plihan tata laksananya adalah operasi Dalam terapi operatif dapat dilakukan dengan dua jenis operasi yaitu reseksi anastomosis langsung atau pembuatan stoma sementara Studi ini dilakukan untuk mengevaluasi keluaran kedua jenis operasi tersebut berupa lama rawat masa awal asupan oral infeksi daerah operasi dan re operasi Metode Studi retrospektif dengan desain potong lintang berdasarkan kelompok jenis operasi reseksi anastomosis langsung atau pembuatan stoma sementara dilakukan di RSCM melalui penelusuran rekam medis Pengambilan sampel secara consecutive sampling dengan kriteria inklusi usia 0 18 th menjalani operasi reseksi anastomosis langsung ditunda di RSCM sedangkan kriteria ekslusi adalah data tidak lengkap atau tidak dilakukan reseksi Data diolah secara statistik dengan analisis komparatif numerik dengan uji Chi square atau uji T tidak berpasangan bila sebaran data normal bila tidak normal dengan uji Mann Whitney Hasil Terdapat 106 subjek dilakukan operasi dengan 40 subjek menjalani operasi reseksi anastomosis langsung dan 46 subjek dengan pembuatan stoma sementara serta 20 subjek dieklusi karena tidak dilakukan reseksi Lama rawat inap dengan median 11 hari 4 36 hari dengan masa awal asupan oral dengan median tiga hari 1 7 hari durasi gejala dengan median tiga hari ABSTRACT
Introduction Intussusception is an emergency that found mostly under two years old which one of the therapy is operative management There are two kinds of operation mostly done which are resection anastomosis and temporary stoma followed by stoma closure This study aims to explain outcome of each techniques operation including length of stay duration to start oral intake surgical site infection and re operation Methods Retrospective study using cross sectional design grouping as resection anastomosis group and temporary stoma group was done at RSCM by reviewing patients rsquo medical records Sample achieved by methods of consecutive sampling with inclusion criterias are ages 0 18 years old underwent surgical resection and anastomosis delayed anastomosis at RSCM hospital while the exclusion criterias are incomplete data or not have surgical resection The data were processed statistically Chi square test or unpaired T test used to analyze comparative numerical variables if data distribution is normal While it rsquo s not normal Mann Whitney test was used Results There were 106 subjects consisted of 40 patients belonged to resection anastomosis group and 46 subjects were temporary stoma group while 20 subjects were exluded Median of overall length of stay was 11 days 4 36 days the median of duration to the first oral intake was 3 days 1 7 days and median of clinical onset was three days