Tesis

Efektivitas Pencucian Luka Dengan Aquadest Dibandingkan Perawatan Luka Standar Terhadap Insidens Infeksi Daerah Operasi Pasca Laparotomi Di Rumah Sakit Cipto Mangunkusumo Tahun 2018 = The Effectiveness of Wound Washing With Aquadest Compared to Standard Wound Treatment On Surgical Site Infections Incidence of Median Laparotomy Wound in Cipto Mangunkusumo Hospital In 2018.

Latar Belakang: Surgical Site Infection (SSI) adalah infeksi sekitar luka operasi dalam kurun waktu 30 hari pascabedah. SSI merupakan 23,6% dari total infeksi nosokomial pascabedah abdomen di RSCM tahun 2009 – 2011. Tingginya angka morbiditas dan mortalitas dikarenakan SSI menyebabkan biaya penangganan SSI, sehingga pencegahan SSI akan mengurangi biaya pengobatan. Aquadest diketahui cairan yang efektif untuk irigasi luka, mudah didapatkan, murah dan aman untuk irigasi luka. Tujuan: Mengetahui pencucian luka dengan aquadest dibanding perawatan luka Standar. Metode: Penelitian ini merupakan penelitian eksperimental terandomisasi tersamar tunggal, yang dilakukan di departemen bedah, Fakultas kedokteran Universitas Indonesia, Rumah Sakit Cipto Mangunkusumo Mei – Juni 2018. Subyek berjumlah 80 orang setelah laparatomi mediana, dibagi menjadi grup kontrol (n=40) yang menerima perawatan standar dengan tulle setiap 2 hari dan grup eksperimental (n=40) yang menerima pencucian luka dengan aquadest setiap hari, dimulai hari kedua pascabedah. Pada hari ketujuh, dilakukan kultur mikrobiologi yang diambil dari benang jahitan. Parameter yang dievaluasi adalah pertumbuhan kuman, tanda infeksi, dan biaya per subyek antara 2 grup untuk mengetahui efisiensi dan efektivitas keduanya. Hasil: Penelitian ini dilakukan pada 80 subjek yang telah memenuhi kriteria inklusi dan eksklusi untuk menentukan efektivitas pencucian luka dibandingkan dengan teknik perawatan luka standar untuk mencegah infeksi daerah operasi setelah laparotomi mediana. Hasil analisis statistik antara kedua kelompok perlakuan terhadap pertumbuhan bakteri dalam hasil kultur menunjukkan tidak ada hubungan yang signifikan (p = 0,82). Dalam penelitian ini juga diamati adanya tanda-tanda infeksi berdasarkan CDC dalam waktu satu minggu perawatan luka. Tanda-tanda infeksi yang diamati dalam penelitian ini adalah tanda infeksi superfisial. Dari hasil analisis tidak ada perbedaan yang signifikan dalam tandatanda infeksi pada dua kelompok perlakuan (p = 1,00). Kesimpulan : Pencucian luka dengan aquadest sama efektifnya dengan perawatan luka standar dalam mencegah infeksi daerah operasi
Kata kunci: Infeksi situs bedah, cuci luka, aquadest, median laparotomi, perawatan luka, kultur bakteri


Background Surgical site infections (SSIs) still a global problem in the surgical field. The report of the Center for Disease Control and Prevention (CDC) in 1999 stated that SSIs reached 38% of all hospital-acquired infections (HAIs). Although this number can be reduced by 2% -5%, according to the CDC report in 2008, it requires global efforts that are not easy and expensive that involve all stakeholders (stakeholders) to achieve that number. In preventing SSIs, wound hygiene is one of the absolute factor. The majority of medical personnel apply the concept of using antiseptics containing various types of antibiotics accompanied by temporary topical antibiotics. However, The best cleanser is water, effective, easy to obtain, and does not require additional fee. Therefore we conducted a study aimed at demonstrating that wound washing is an efficient SSIs prevention measure eventhough it is done at RSCM. If the results of this study are meaningful then postoperative wound care at RSCM will be more economical because the materials needed for wound care are inexpensive. Method This research is a randomized experimental study. Randomization will be done in a single blind manner. The patient will not know whether he is a control or experimental group. The research team will objectively evaluate germs according to each treatment group. This research was conducted in the Medical Department of Surgery, Faculty of Medicine, University of Indonesia - RSCM for the period January - July 2018. The target population in this study were all patients undergoing postoperative wound care. Result This study was conducted on 80 subjects who had met the inclusion and exclusion criteria to determine the effectiveness of wound washing compared to standard wound care techniques for the rate of infection in the area of surgery after median laparotomy. The results of statistical analysis between the two treatment groups on bacterial growth in culture results showed no significant relationship (p = 0.82). In this study also observed the presence of signs of infection based on CDC within a week of wound care. Signs of infection observed in this study are a sign of superficial infection. From the results of the analysis there were no significant differences in signs of infection in the two treatment groups (p = 1.00). Conclusion Washing wounds with aquadest is as effective as standard wound care in preventing infection in the surgical site.
Keywords Surgical site infection, wound washing, aquadest, median laparotomy, wound care, bacterial culture