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"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"

"Pendahuluan: Infeksi luka operasi superfisial merupakan komplikasi yang sering muncul pada tatalaksana operatif fraktur tulang panjang. Untuk mencegah terjadinya infeksi tersebut, diberikan antibiotik profilaksis sebelum operasi, yang kemudian dilanjutkan dengan antibiotik terapeutik. Penelitian ini bertujuan untuk membandingkan angka kejadian infeksi luka operasi superfisial antara pemberian antibiotik profilaksis intravena saja dan yang diteruskan dengan pemberian antibiotik oral selama 7 hari pasca operasi.Metode: Penelitian ini menggunakan desain studi klinis non-inferioritas terkontrol tersamar ganda. Sampel penelitian adalah pasien dewasa yang menjalani operasi elektif reposisi terbuka fiksasi interna untuk kasus fraktur tertutup tulang panjang di RSUPN Dr. Cipto Mangunkusumo Jakarta dan RSU Siaga Medika Banyumas pada bulan Juli 2022 hingga Maret 2023. Subjek penelitian dibagi secara acak menjadi dua kelompok, yakni kelompok tanpa pemberian antibiotik oral selama 7 hari pasca operasi (perlakuan) dan kelompok dengan pemberian antibiotik oral selama 7 hari pasca operasi (kontrol). Hasil: Penelitian ini melibatkan 80 subjek yang memenuhi kriteria inklusi dan eksklusi, yang terdiri dari 47 (58,75%) subjek laki-laki dan 33 (41,25%) subjek perempuan. Angka kejadian infeksi luka operasi superfisial baik pada kelompok perlakuan dan kontrol adalah 2,5%. Pada hari ke-30 pasca operasi, terdapat 1 (2,5%) kejadian infeksi baik di kelompok perlakuan maupun kontrol. Hasil tersebut secara statistik tidak berbeda bermakna (p = 1.000).Kesimpulan: Tidak terdapat perbedaan yang bermakna dalam kejadian infeksi luka operasi superfisial antara kelompok dengan maupun tanpa pemberian antibiotik oral selama 7 hari pasca operasi.

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Introduction: Superficial surgical site infection is a common complication in the operative management of long bone fractures. To prevent the infection, prophylactic antibiotics are given prior to surgery, followed by therapeutic antibiotics. This study aimed to compare the superficial surgical site infection rate between subjects who was given intravenous prophylactic antibiotic only and those with continued oral antibiotic for 7 days postoperatively.

Method: This study was a double-blind, controlled, non-inferiority clinical study. The sample was adult patients who underwent open reduction internal fixation surgery for closed long bone fractures at Dr Cipto Mangunkusumo Central Hospital Jakarta and Siaga Medika Hospital Banyumas from July 2022 to March 2023. The subjects of the study were randomized into two groups, namely the group without oral antibiotics for 7 days postoperatively (treatment) and the group with oral antibiotics for 7 days postoperatively (control).

Result: This study involved 80 subjects who met the inclusion and exclusion criteria, consisting of 47 (58.75%) male and 33 (41.25%) female subjects. The superficial surgical site infection rate in both treatment and control groups were 2,5%. At day 30 post- operation, there was one case of infection both on the treatment and control groups. The results showed no statistically significant difference (p = 1.000).

Conclusion: There was no significant difference in the superficial surgical site infection rate between the groups with and without oral antibiotics for 7 days postoperatively."

"Bedah merupakan salah satu prosedur medis yang dilakukan secara manual dan menyebabkan banyak perlukaan dan berisiko tinggi menyebabkan infeksi Adanya infeksi harus ditangani dengan antibiotika empiris yang tepat dan rasional. Penelitian ini dilakukan untuk memperoleh data penggunaan antibiotika empiris pada pasien pascabedah di Ruang ICU RSAL Dr Mintohardjo selama periode 2012 2013 dan melakukan evaluasi kerasionalannya dilihat dari ketepatan pasien ketepatan indikasi ketepatan obat ketepatan dosis dan interaksi obat. Penelitian dilakukan dengan pengambilan data penggunaan antibiotik empiris dari rekam medis pasien pascabedah dengan metode retrospektif dengan desain cross sectional. Pengambilan sampel penelitian dilakukan dengan tekniktotal sampling. Populasi penelitian berjumlah 299 pasien dan 35 pasien diterima sebagai sampel penelitian. Pada penilaian terhadap jumlah pasien pascabedah terdapat 100 pasien mendapatkan terapi antibiotik tepat dengan kondisi pasien 11 43 pasien mendapatkan antibiotik sesuai indikasi 0 pasien mendapatkan antibiotik tepat obat 85 71 pasien sudah mendapatkan dosis yang tepat dan 51 43 pasien tidak mengalami interaksi obat. Sehingga dapat disimpulkan pengobatan antibiotik empiris pada pasien pascabedah di RSAL Dr Mintohardjo tidak rasional.

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Surgery is a manual medical procedure which causes many wounds and has a high infection risk Patient who has infection must be given antibiotic immediatelyand rationally. The aim of this study was to collect empiric antibiotics usage data in Intensive Care Unit of Naval Hospital Dr Mintohardjo 2012 2013 and to evaluate rationality of the administration through the appropriate patient appropriate indication appropriate drug appropriate dose and drugs interaction. This retrospective cross sectional study was done by collecting empiric antibiotics usage data from medical record of postoperative patients on 2012 2013 using total sampling. Population of study included 299 patients and 35 patients were accepted as samples of study. Appropriate assessment based on number of postoperative patients showed 100 appropriate patient 11 43 appropriate indication 0 appropriate drug 85 71 appropriate dose and 31 43 no drugs interaction. It was concluded that empirical antibiotic treatment in postoperative patients in Naval Hospital Dr Mintohardjo were irrational."

"Kejadian infeksi pasca pembedahan dan pasca kemoterapi pada pasien kanker payudara dapat memperpanjang lama rawat inap sehingga meningkatkan biaya kesehatan. Meningkatnya biaya pengeluaran kesehatan mendorong adanya evaluasi ekonomi. Analisis efektivitas-biaya (AEB) sebagai salah metode farmakoekonomi penting dilakukan untuk membandingkan antibiotik yang digunakan. Penelitian ini bertujuan untuk membandingkan total biaya penggunaan, efektivitas seftriakson generik A dan B, dan menentukan seftriakson yang lebih cost-effective untuk pasien kanker payudara di RS Kanker Dharmais tahun 2012. Desain penelitian ini adalah non eksperimental dengan studi perbandingan dan pengambilan data secara retrospektif menggunakan data sekunder dari rekam medis dan Sistem Informasi Rumah Sakit RS Kanker Dharmais. Pengambilan sampel dilakukan secara total sampling. Jumlah sampel sebanyak 16 pasien untuk seftriakson generik A dan 8 pasien untuk generik B.Efektivitas seftriakson pada indikasi pasca pembedahan untuk generik A sebesar 2,5 hari dan untuk generik B sebesar 1,0 hari, sedangkan pada indikasi pasca kemoterapi untuk generik sebesar 4,0 hari dan untuk generik B sebesar 9,5 hari. Total biaya penggunaan seftriakson pada indikasi pasca pembedahan untuk generik A sebesar Rp 4.384.448,00 dan untuk generik B sebesar Rp 3.397.952,00,sedangkan pada indikasi pasca kemoterapi untuk generik A sebesar Rp2.284.655,00 dan untuk generik B sebesar Rp 11.195.270,00. Berdasarkan AEB,pada indikasi pasca pembedahan diperoleh hasil seftriakson generik B lebih costeffective daripada generik A, sedangkan pada indikasi pasca kemoterapi diperoleh hasil seftriakson generik A lebih cost-effective daripada generik B.

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The incidence of post-surgery and post-chemotherapy infections in breast cancer patients prolonged the hospitalization days leading to the increase of health costs.The increasing health expenditure demanded the use of economic evaluation.Cost-effectiveness analysis (CEA) as one of pharmacoeconomics methods was important to compare the usage of antibiotics. The purposes of this research were to compare total cost and effectiveness of using generic ceftriaxone A and B, and to decide which ceftriaxone that was more cost-effective in breast cancer patients in Dharmais Cancer Hospital during 2012. Effectiveness was measured as ceftriaxone-using days, meanwhile cost was measured as total direct medical cost.

The research design was non experimental with comparative study and retrospective data were collected from medical records and hospital information systems of Dharmais Cancer Hospital. Samples were taken by using total sampling method. There were 6 patients using generic ceftriaxone A and 8 generic ceftriaxone B. Effectiveness of ceftriaxone for post-surgery indication in generic ceftriaxone A was 2,5 days and in generic B was 1,0 days, meanwhile for postchemotherapy indication in generic A was used 4,0 days and in generic B was 9,5 days.

Total direct medical cost of ceftriaxone for post-surgery indication in generic A and B, respectively Rp 4.384.448,00 and Rp 3.397.952,00, meanwhile for post-chemotherapy indication in generic A and B, respectively Rp 2.284.655,00 and Rp 11.195.270,00. According to CEA result, it could be concluded that generic ceftriaxone B was more cost-effective than A for postsurgery indication, meanwhile generic ceftriaxone A was more cost-effective than B for post-chemotherapy indication."

"ABSTRACTInfeksi luka operasi merupakan infeksi yang terjadi 30 hari pasca operasi. Angka kejadian ILO di RSUP Fatmawati dari tahun 2014-2016 mengalami peningkatan dari 0,74 menjadi 1,24. Tahun 2016 0,3 dari total angka kejadian ILO berasal dari pasien kebidanan dan kandungan. Tujuan dari penelitian ini adalah merumuskan upaya perbaikan pencegahan kejadian infeksi luka operasi sehingga diharapkan dapat mengurangi kejadian infeksi luka operasi di RSUP Fatmawati. Penelitian ini merupakan jenis penelitian operasional yang bersifat kuantitatif dan kualitatif. Metode yang digunakan adalah telaah data sekunder, wawancara mendalam, observasi dan telaah dokumen. Hasil penelitian menunjukkan bahwa ILO masih terjadi di RSUP Fatmawati walaupun rumah sakit sudah mempunyai SOP terkait ILO untuk melakukan pencegahan dan pengendalian ILO, karena ILO bisa terjadi dari sisi kondisi pasien dan sistem pelayanan rumah sakit. Maka dari itu diperlukan kerjasama dan komitmen antar seluruh pihak yang berkaitan dengan pencegahan dan pengendalian ILO, yakni Instalasi Rawat Inap Teratai, Instalasi Bedah Sentral, KPPI dan Komite Mutu serta diperlukan penelitian lanjutan untuk membahas faktor lain yang tidak terdapat dalam penelitian ini.

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ABSTRACTSurgical site infections is infection that occurs within 30 days after the operation. The incidence rate of SSI at RSUP Fatmawati has increased from 0.74 to 1.24 in 2014 2016. In 2016, there is 0.3 of total incidence SSI that came obstetric and gynaecological patients. The aim of this study is formulate improved preventive incidence of SSIs so that can reduce incidence of SSIs at RSUP Fatmawati. This research is an operational research, which use quantitative and qualitative approach. The method are secondary data review, observation, interviews, and documents review. The results showed that there is still incidence of SSIs at RSUP Fatmawati despite having Standard Operating Procedure SOP for prevention and controlling of SSIs, because SSIs caused of patients condition and hospital service system. Therefore it is necessary to do cooperation and commitment among people concerned in prevention and controlling of SSIs, i.e., Central Surgical Installation and Teratai rsquo s Inpatient Installation, IPCN, and Quality Committe, and further research is needed to discuss other factors not used in this study."

"ABSTRAK Latar Belakang : Angka kejadian reseksi anastomosis pada kasus intususepsi masih sangat tinggi. Hal ini dikarenakan masih seringnya pasien datang terlambatsetelah 72 jam, kurangnya SDM untuk melakukan reduksi non operatif, dankurangnya penunjang seperti USG untuk menegakkan diagnosa. Penting untukmemperhatikan presisi, tehnik dan mempertimbangkan usus yang tersisa dalammelakukan reseksi anastomosis. Hingga saat ini belum ada standar operasi khususyang dapat menjadi panduan bagi para dokter bedah dalam melakukan reseksiakibat intususepsi. Karena itu, peneliti tertarik untuk mencari batas reseksi yangdiperlukan untuk menghasilkan suatu anastomosis end-to-end yang optimal danrendah tingkat kebocorannya. Penelitian akan dilakukan kepada tikus sebagai pilotstudy sebelum dilakukan penelitian lebih lanjut. Tujuan : Mengetahui batas reseksi usus yang optimal dinilai dari kebocorananastomosis berdasarkan grading kolagen pada batas reseksi tersebut. Metode : Penelitian ini merupakan penelitian eksperimental dengan hewan cobatikus putih Sprague Dawley. Tikus putih dilakukan intususepsi denganmenggunakan stylet, dari proksimal ke distal. Setelah 45 menit, intususepsi direduksi.Tikus putih dikelompokkan dalam tiga kelompok sesuai batas reseksianastomosis, yang kemudian batas reseksi ini dilakukan pemeriksaan gradingkolagen. Setelah 5 hari, dilakukan laparotomi untuk menilai kebocorananastomosis. Hasil : Pada perbandingan grading kolagen dengan reseksi usus didapatkangrading terbanyak pada batas 1 adalah grading 2 (57,1 %), pada batas 2 grading 2(71,4 %) ,batas 3 grading 3 (71,4%).Perforasi terbanyak ditemukan pada grading 2 sebanyak 5 sampel. Pada perbandingan batas reseksi dengan perforasi didapatkan perforasi terbanyak pada batas 1 (85,7 %)Simpulan : Terdapat perbedaaan grading kolagen pada batas reseksi usus dimana batas kelompok batas 3 memiliki grading kolagen yang lebih baik ( grade 3 dan 4)sehingga kelompok batas 3 lebih direkomendasikan secara histopatologis.Grading kolagen dapat dinilai untuk melihat kemungkinan perforasi hasilanastomosis. Terdapat faktor-faktor lain yang dapat mempengaruhi kejadian perforasi selain grading kolagen. ;Background ABSTRACT There is still high presentation of intussuseption cases with resection andanastomose, caused of multi factors as : patient delay more than 72 hours, less onprofesional expert to do non operative reduction and less of examination such as ultrasound to make a diagnose. That is important to take attention with pretition, tehniquesand less of intestine when do the resection. There is still no operative standard about theboundary of resection cause of intussuseption, thats why the author want to do theexperimental to find the optimal part of resection with minimal leakage. The experimental will do on rat as a pilot study. Aim : How to get the optimal part of resection compared with anastomotic leakege basedon collagen grading. Method : The experimental test using a Sprague Dawley rat. We make a intussuseptionon gut rat using a styleth from proximal to distal. The release do after 45 minutes. Therats then separated into three boundaries group, and did resection-anastomose with eachgut from groups were performed a histopatologic test to count collagen grading. Leakageof anastomose were examinated after 5 days Result : In comparison between collagen grading and the extent of resectionobtained the highest grading in group 1 is grade 2 (57,1%), group 2 is grade 2(71,4%), group 3 (71,4%). The highest Leakage can be found on grade 2 (5sample).in comparison the extent of resection and leakage,the highest is group 1(85,7%). Summary : There are differences about collagen gradingin the extent of bowelresection which is the third group of resection has higher collagen grading (3 and4 ) and then more recommended as histopatologic exam. Collagen grading couldbe marked to see possibilities of anastomotic leakage. There is some factors thataffect a leakage besides collagen grading. ;Background : There is still high presentation of intussuseption cases with resection andanastomose, caused of multi factors as : patient delay more than 72 hours, less onprofesional expert to do non operative reduction and less of examination such as ultrasound to make a diagnose. That is important to take attention with pretition, tehniquesand less of intestine when do the resection. There is still no operative standard about theboundary of resection cause of intussuseption, thats why the author want to do theexperimental to find the optimal part of resection with minimal leakage. The experimental will do on rat as a pilot study. Aim : How to get the optimal part of resection compared with anastomotic leakege basedon collagen grading. Method : The experimental test using a Sprague Dawley rat. We make a intussuseptionon gut rat using a styleth from proximal to distal. The release do after 45 minutes. Therats then separated into three boundaries group, and did resection-anastomose with eachgut from groups were performed a histopatologic test to count collagen grading. Leakageof anastomose were examinated after 5 days Result : In comparison between collagen grading and the extent of resectionobtained the highest grading in group 1 is grade 2 (57,1%), group 2 is grade 2(71,4%), group 3 (71,4%). The highest Leakage can be found on grade 2 (5sample).in comparison the extent of resection and leakage,the highest is group 1(85,7%). Summary : There are differences about collagen gradingin the extent of bowelresection which is the third group of resection has higher collagen grading (3 and4 ) and then more recommended as histopatologic exam. Collagen grading couldbe marked to see possibilities of anastomotic leakage. There is some factors thataffect a leakage besides collagen grading. ;Background : There is still high presentation of intussuseption cases with resection andanastomose, caused of multi factors as : patient delay more than 72 hours, less onprofesional expert to do non operative reduction and less of examination such as ultrasound to make a diagnose. That is important to take attention with pretition, tehniquesand less of intestine when do the resection. There is still no operative standard about theboundary of resection cause of intussuseption, thats why the author want to do theexperimental to find the optimal part of resection with minimal leakage. The experimental will do on rat as a pilot study. Aim : How to get the optimal part of resection compared with anastomotic leakege basedon collagen grading. Method : The experimental test using a Sprague Dawley rat. We make a intussuseptionon gut rat using a styleth from proximal to distal. The release do after 45 minutes. Therats then separated into three boundaries group, and did resection-anastomose with eachgut from groups were performed a histopatologic test to count collagen grading. Leakageof anastomose were examinated after 5 days Result : In comparison between collagen grading and the extent of resectionobtained the highest grading in group 1 is grade 2 (57,1%), group 2 is grade 2(71,4%), group 3 (71,4%). The highest Leakage can be found on grade 2 (5sample).in comparison the extent of resection and leakage,the highest is group 1(85,7%). Summary : There are differences about collagen gradingin the extent of bowelresection which is the third group of resection has higher collagen grading (3 and4 ) and then more recommended as histopatologic exam. Collagen grading couldbe marked to see possibilities of anastomotic leakage. There is some factors thataffect a leakage besides collagen grading. ;Background : There is still high presentation of intussuseption cases with resection andanastomose, caused of multi factors as : patient delay more than 72 hours, less onprofesional expert to do non operative reduction and less of examination such as ultrasound to make a diagnose. That is important to take attention with pretition, tehniquesand less of intestine when do the resection. There is still no operative standard about theboundary of resection cause of intussuseption, thats why the author want to do theexperimental to find the optimal part of resection with minimal leakage. The experimental will do on rat as a pilot study. Aim : How to get the optimal part of resection compared with anastomotic leakege basedon collagen grading. Method : The experimental test using a Sprague Dawley rat. We make a intussuseptionon gut rat using a styleth from proximal to distal. The release do after 45 minutes. Therats then separated into three boundaries group, and did resection-anastomose with eachgut from groups were performed a histopatologic test to count collagen grading. Leakageof anastomose were examinated after 5 days Result : In comparison between collagen grading and the extent of resectionobtained the highest grading in group 1 is grade 2 (57,1%), group 2 is grade 2(71,4%), group 3 (71,4%). The highest Leakage can be found on grade 2 (5sample).in comparison the extent of resection and leakage,the highest is group 1(85,7%). Summary : There are differences about collagen gradingin the extent of bowelresection which is the third group of resection has higher collagen grading (3 and4 ) and then more recommended as histopatologic exam. Collagen grading couldbe marked to see possibilities of anastomotic leakage. There is some factors thataffect a leakage besides collagen grading. "

"Penyembuhan luka adalah peristiwa kompleks yang meliputi kemotaksis, angiogenesis, pembelahan sel, sintesis matriks ekstraseluler, pembentukan dan remodeling jaringan parut. Angiogenesis, densitas kolagen, kontraksi luka, epitelisasi dan luas area luka adalah beberapa parameter yang dapat digunakan untuk menilai baiknya penyembuhan luka. Pemberian ADSC-CM pada penelitian terdahulu terbukti meningkatkan proses penyembuhan luka melalui mekanisme parakrin ADSC. Penelitian ini menilai efek pemberian ADSC-CM monolayer dalam inkubasi normoxia selama tiga hari terhadap angiogenesis, kontraksi luka, epitelisasi dan kualitas penyembuhan luka kulit tikus Sprague Dawley. Adanya konsentrasi growth factor seperti VEGF dan EGF dinilai melalui pemeriksaan ELISA. Efek angiogenesis, densitas kolagen, kontraksi luka, epitelisasi dan luas area luka dinilai dengan pemeriksaan histologi menggunakan pewarnaan Hematoksilin-Eosin dan Masson’s Trichome. Dua puluh sembilan tikus dibalurkan ADSC-CM pada bagian punggung (full thickness wound) dan dinilai gambaran histologinya pada hari ke-3, 7, 14, 21 dan 28.  Konsentrasi VEGF dan EGF ditemukan dalam ADSC-CM dengan 5052,698 ± 0,31 pg/mL dan 0,233 ± 0,08 pg/mL. Gambaran histologi pada parameter angiogenesis, densitas koalgen, kontraksi luka, epitelisasi dan luas area luka menunjukkan perbedaan tidak bermakna antara kelompok luka yang dibalurkan ADSC-CM dan kelompok kontrol namun secara klinis dan epidemiologis pembaluran ADSC-CM meningkatkan proses penyembuhan luka.

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Wound healing is a complex event that consist chemotaxis, angiogenesis, proliferation, synthesis of matrix extracellular, formation and remodeling scar tissue. Angiogenesis, colagen density,  wound contraction, epithelialization and wound area is a several parameter to analyze wound healing. Previous studies have shown that ADSC-CM are able to accelerate wound healing due to paracrine effect. This study investigate the effect of monolayer ADSC-CM on angiogenesis, colagen density, wound contraction, epithelialization and wound area in a rat full thickness wound. Consentration of growth factor such as EGF and VEGF were assessed with ELISA examination. Angiogenesis, colagen density, wound contraction, epithelialization and wound area were analyzed histologically with Hematoxylin-Eosin and Masson’s Trichome staining. Twenty nine rats were administered topically with ADSC-CM. Histological examination was measured on day 3, 7, 14, 21 and 28.  Amount of VEGF and EGF is 5052,698 pg/mL dan 0,233 pg/mL. Histology examination angiogenesis, colagen density, wound contraction, epithelialization and wound area show there is no significant difference between ADSC-CM group and control group but meaningful difference to accelerate wound healing."

"Pendahuluan. Kebocoran anastomosis merupakan komplikasi yang berat berhubungan dengan peningkatan morbiditas, dan mempengaruhi lama rawat di rumah sakit. Banyak peneliti yang telah meneliti faktor resiko terjadinya kebocoran usus, diantaranya sepsis, malnutrisi, ketegangan garis anastomosis, gangguan perfusi jaringan, obstruksi distal, dll. Usus adalah organ yang rentan terhadap cedera, cedera pada usus dapat menyebabkan edema, ileus, dan kegagalan mekanisme pertahanan usus. Kondisi ini dapat ditemukan pada gastroshizis, invaginasi, strangulasi, penyakit radang usus dan sirosis. Pemberian cairan berlebih dapat menyebabkan edema, peningkatan tekanan intra abdomen, menurunkan aliran darah mesenterik, berpengaruh terhadap penyembuhan dan meningkatkan kebocoran anastomosis. Studi ini bertujuan untuk mengetahui pengaruh edema terhadap anastomosis usus. Metode. Studi eksperimental pada tikus Sprague–Dawley untuk mengetahui pengaruh edema dan pemberian cairan yang berlebihan terhadap anastomosis usus. Hasil. Tidak terdapat perbedaan antara edema usus dan pemberian cairan berlebihan dengan peningkatan kebocoran anastomosis (p=0,178)  Kesimpulan. Edema usus tidak ada hubungan dengan kebocoran anastomosis.

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Introduction. Anastomotic leak is a severe complication associated with increased morbidity, and affects hospital stay. Many researchers have examined risk factors for intestinal leakage, including sepsis, malnutrition, anastomotic line tension, impaired tissue perfusion, distal obstruction, etc. The intestine is an organ that is prone to injury, injury to the intestine can cause edema, ileus, and failure of the intestinal defense mechanism. This condition can be found in gastroshizis, invagination, strangulation, inflammatory bowel disease and cirrhosis. Excessive fluid can cause edema, increase intra-abdominal pressure, decrease mesenteric blood flow, affect healing and increase anastomotic leakage. This study is to investigate intestinal edema on anastomosis. Method. This is an experimental study using Sprague-Dawley to determine the effect of edema and excessive fluid administration on intestinal anastomosis Results. There was no difference between intestinal edema and excessive fluid administration with increased anastomotic leak (p = 0.178). Conclusion. Intestinal edema is not associated with anastomotic leakage."

"Ibu hamil menjadisalah satu kelompok masyarakat yang rentan terinfeksi COVID-19 akibat adanya perubahan fisiologis tubuh. Beberapa penelitian menunjukkan pandemi COVID-19 memengaruhi perawatan selama kehamilan, meningkatkan angka kehamilan risiko tinggi, dan meningkatkan mortalitas padaibu dan bayinya. Menurut WHO, peningkatan jumlah persalinan dengan metode Sectio Caesaria (SC) berbanding lurus dengan peningkatan kejadian infeksi daerah operasi (IDO). Tujuan penelitian ini yaitu menganalisis faktor-faktor intrinsik (umur pasien, status gizi, anemia, kejadian perdarahan)dan faktor ekstrinsik ( pengetahuan tenaga kesehatan tentang pengendalian infeksi rumah sakit, kepatuah kebersihan tangan tenaga kesehatan, kepatuhan penggunaan alat pelindung diri tenaga kesehatan, lama waktu operasi dan penggunaan antibiotika profilaksis) yang menyebabkan kejadian IDO pada pasien pasca-SC selama pandemi COVID-19 di RSUD Bali Mandara. Penelitian menggunakan desain kuantitatif analitik korelasional cross-sectional. Sampel penelitian 183 tenaga kesehatan yang bertugas di ruang perawatan pasca- SC dengan menggunakan rule of thumb dan instrumen penelitiannya berupa kuisioner dan lembar observasi. Data faktor intrinsik diambil dari rekam medis (umur pasien, status gizi, anemia, serta kejadian perdarahan) kemudian dianalisis secara univariat dan bivariat. Dari variabel umur pasien rata-rata berusia 28,19 tahun (26,2–30,15) dengan pasien yang mengalami IDO cenderung lebih muda. Mayoritas subjek mengalami anemia, baik pada kelompok pasien yang mengalami maupun yang tidak mengalami IDO. OR pasien anemia yang mengalami IDO adalah 0,652 sehingga menunjukkan sifat protektif.Dari faktor ekstrinsik diperoleh nilai median pengetahuan nakes tentang pengendalian infeksi sangat baik dengan rata-rata 90 (85,89–90,36). Selain itu, nilai mean kepatuhan kebersihan tangan nakes adalah 3,35 (3,23–3,47) yang berarti sangat baik. sementara nilai median dari faktor kepatuhan penggunaan APD nakes adalah 16 (14,66-15,59) dengan nilai maksimum 16. Pada lama operasi, dengan median yang didapat 42 (41,88–45,18) menit masih serupa dengan standar rerata lama SC (45 menit). Analisis Mann-Whitney menunjukkan bahwa terdapat perbedaan peringkat lama waktu operasi pasien yang tidak signifikan pada pasien yang mengalami IDO pasca-SC dan yang tidak mengalami IDO.Pada penggunaan antibiotika profilaksis, sebagian besar pasien penelitian menggunakannya (RR = 0,16), menunjukkan faktor umur pasien menjadi faktor intrinsik dan kepatuhan pengunaan APD menjadi faktor ekstrinsik yang memengaruhi kejadian IDO pasien COVID-19 pasca SC tahun 2020 di RSUD Bali Mandara. Asuhan antenatal yang terfokus bekerja sama dengan fasilitas kesehatan primer,serta pemangku kebijakan dalam menyiapkan fasilitas kesehatan yang memadai bagi pasien dan tenaga kesehatan serta membangkitkan kesadaran untuk menjaga kesehatan ibu dan bayi oleh pasien dan keluarga merupakan salah satu upaya menurunkan angka IDO.

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Pregnant women are one of the groups of people who are vulnerable to being infected with COVID-19 due to physiological changes in the body. Several studies have shown that the COVID-19 pandemic is affecting care during pregnancy, increasing the rate of high-risk pregnancies, and increasing mortality for both mother and baby. According to WHO, the increase in the number of deliveries using the C-Section (CS) method is directly proportional to the increase in the incidence of surgical site infections (SSI). The purpose of this study was to analyze intrinsic factors (patient age, nutritional status, anemia, bleeding incidence) and extrinsic factors (knowledge of health care workers in hospital infection control, hand hygiene compliance, compliance with the use of personal protective equipment, duration of surgery and use of prophylactic antibiotics). which caused the incidence of SSI in post-CS patients during the COVID-19 pandemic at the Bali Mandara Hospital. This study uses a cross-sectional correlational analytic quantitative design. The research sample was 183 health workers who served in the post-CS treatment room using the rule of thumb and research instruments are form of questionnaires and observation sheets. Intrinsic factor data were taken from medical records (patient age, nutritional status, anemia, and bleeding incidence) and then analyzed by univariate and bivariate. From the age variable, the average patient was 28.19 years (26.2–30.15) with patients experiencing SSI which tended to be younger. The majority of subjects in this study were anemic, both in the group of patients with and without SSI. The OR of anemic patients with SSI was 0.652, indicating protective properties.

From extrinsic factors, the median knowledge of health workers about infection control was very good with an average of 90 (85.89–90.36). In addition, the mean hand hygiene compliance of health workers was 3.35 (3.23–3.47) which means very good. while the median value of the compliance factor for the use of PPE for health workers is 16 (14.66- 15.59) with a maximum value of 16. In the length of operation, the median obtained is 42 (41.88-45.18) minutes, which is still similar to the standard length of time CS(45 minutes). The Mann-Whitney analysis showed that there was a non-significant difference in the ratings for the duration of surgery for patients with post-CS SSI and those without SSI. In the use of prophylactic antibiotics, most of the study patients used them (RR = 0.16), indicating a factor The patient's age is an intrinsic factor and compliance with the use of PPE is an extrinsic factor that affects the incidence of SSI in post-CS COVID-19 patients in 2020 at the Bali Mandara Hospital. Antenatal care that focuses on collaborating with primary health facilities, as well as policy makers in preparing adequate health facilities for patients and health workers as well as raising awareness to maintain maternal and infant health by patients and families is one of the efforts to reduce SSI rates."

"Latar belakang. Penderita hemodialisis memerlukan kanulasi arteriovena.Selama ini diperlukan waktu tunggu hingga empat minggu agar fistula arteriovenasiap digunakan. Hal ini meningkatkan morbiditas dan biaya. Diperlukan suatupenelitian untuk mengetahui efektifitas fistula arteriovena pada waktu tungguyang lebih singkat.Metode. Studi potong lintang komparatif membandingkan kelompok kanulasi duaminggu dan empat minggu, menggunakan data sekunder dari RS.P pada kurunwaktu 2010 – 2012. Penilaian efektifitas menggunakan pemeriksaan thrill.Hasil. Terdapat 174 data subyek yang memenuhi kriteria, dimana tidak ditemukanperbedaan thrill pada kelompok kanulasi dua minggu dan empat minggu. Dimanaefekifitas keduanya diatas 90 %. Pada analisis statistik hanya riwayat CVD yangberhubungan dengan hasil kanulasi empat minggu.Pembahasan. Tidak terdapat perbedaan efektifitas pemasangan kanulasi padakelompok dua minggu dan empat minggu, sehingga waktu tunggu untukhemodialisis dapat diusulkan menjadi dua minggu.

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Background. Hemodyalisis patients requires arteriovenous cannulation. It’s

needed a waiting period for up to four weeks for arteriovenous fistula ready for

use. It will increases morbidity and cost. It’s required a study to determine the

effectiveness of the arteriovenous fistula on a shorter waiting period.

Methods. Comparative cross-sectional study comparing the cannulation two

weeks and four weeks, using secondary data from RS.P in the period from 2010 to

2012. Assessing the effectiveness of using thrill.

Results. There were 174 subjects who met the criteria of data, which is not found

on thrill difference between cannulation two weeks and four weeks. Where both

effectiveness were above 90%. In the statistical analysis only the history of CVD

associated with cannulation results four weeks.

Discussion. There was no difference in the effectiveness of the installation of

cannulation in group two weeks and four weeks, so the waiting period for

hemodialysis may be proposed in two weeks"