pendekatan diagnostik akut

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PENDEKATAN DIAGNOSTIK AKUT ABDOMEN

Mar 18

Posted by herrysyu

PENDEKATAN DIAGNOSTIC Acute AbdomenPENDAH!AN

ntu" memaham# Art# dar# Ist#$ah %acute abdomen& #tu suatu yan' menanda"an "e$a#nan

nontraumat#" s(ontan dan t#ba)t#ba yan' man#*estas# utamanya d# re'#o abdomen den'an 'e+a$a

utamanya b#asanya nyer#, mun'"#n memer$u"an t#nda"an o(erat#-e b#$a $eb#h dar# . +amber$an'sun'nya,, Karena b#asanya (enyebab "e$a#nan #ntra abdomen bers#*at (ro'res#*/ ma"a

t#da" ba#" ter$ambat da$am d#a'nos#s dan (enata$a"sanaan "arena mem(erburu" has#$ tera(#,

!an'"ah (ende"atan "e(ada (as#en den'an "eadaan acute abdomen harus te$#t# dan se"sama,San'"aan adanya Acute abdomen harus teta( d#cur#'a# bah"an +#"a (as#en hanya mem(unya#

'e+a$a r#n'an dan aty(#ca$, Anamnes#s dan (emer#"saan *#s#" d#$a"u"an untu" menemu"an"emun'"#nan (enyebab dan men'arah"an (#$#han untu" meneta("an d#a'nos#s utama, Seoran'K$#n#s# $a$u memutus"an +#"a obser-as# d# rumah sa"#t men+am#n/ "a$au (emer#"saan tambahan

d#butuh"an/ +#"a o(eras# a0a$ d##nd#"as#"an/ atau +#"a (era0atan nono(erat#* $eb#h d#(er$u"am,

Ke0a+#ban "$#n#s# harus se"sama men'ena$# t#mbu$nya 'e+a$a umum dar# (enyebab terser#n' dar#

acute abdomen, Ter$eb#h $a'#/ mere"a harus men'ena$# 'e+a$a (enya"#t yan' s(es#*#" (ada0#$ayah endem#" dan tem(at mere"a (ra"te",

Penyebab umum acute abdomen

1, Tra"tus 'astro#ntest#na$) Nyer# abdomen nons(es#*#"

) A((end#c#t#s

) Obstru"s# usus ha$us dan "o$on) Per*oras# (ada (e(t#c u$ser

) Hern#a #n"arserata

) Per*oras# usus

) D#-ert#cu$#t#s

, Hat#/ s($een dan em(edu

) A"ut "o$es#st#s#s

) A"ut "ho$an'#t#s) Abses he(ar

) He(at#t#s a"ut

) In*ra" s($een2, Pancreas) A"ut (ancreat#t#s

3, Tra"tus ur#nar#us

) Ko$#" rena$) A"ut (ye$one*r#t#s

4, G#ne"o$o'#

) A"ut sa$(#n'#t#s
http://herrysetyayudha.wordpress.com/2012/03/18/pendekatan-diagnostik-akut-abdomen-6/http://herrysetyayudha.wordpress.com/2012/03/18/pendekatan-diagnostik-akut-abdomen-6/http://herrysetyayudha.wordpress.com/author/herrysyu/http://herrysetyayudha.wordpress.com/2012/03/18/pendekatan-diagnostik-akut-abdomen-6/http://herrysetyayudha.wordpress.com/author/herrysyu/http://herrysetyayudha.wordpress.com/2012/03/18/pendekatan-diagnostik-akut-abdomen-6/


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) Keham#$an e"to(#" yan' ru(tur

., 5ascu$ar

) Acute #schem#c co$#t#s) Mesenter#c thrombos#s

6, Per#toneum

) Abses #ntra abdom#na$) Per#ton#t#s tuber"u$os#s

8, 7etro(er#toneum

) Perdarahan retro(er#toneum

ANAMNESISNyer# Perut

Me$a"u"an Anamnes#s yan' berdasar"an (en'a$aman (emer#"sa ada$ah (roses a"t#* d#mana

se+um$ah "emun'"#nan d#a'nos#s d#ter#ma untu" men'e$#m#nas# "eadaan yan' "uran' coco",Nyer# ada$ah 'e+a$a yan' (a$#n' umum dan ser#n' muncu$ (ada acute abdomen, Hat#)hat# da$am

mem(ert#mban'"an $o"as#/ +en#s t#mbu$nya dan (er"emban'an/ dan "ara"ter#st#" dar# nyer# a"an

men'e$#m#nas# a0a$ d#a'nos#s band#n',a, !o"as# Nyer#

Karena dua "om($e"s (ersara*an sensor#s -#sera$ dan (ar#eta$ yan' mem(ersara*# re'#o abdomen/

nyer# t#da" te(at ter$o"a$#sas# d# tem(at #tu, ntun'nya/ bebera(a 'e+a$a umum muncu$ untu"

member#"an (etun+u" d#a'nos#s, 7an'san'an -#sera$ d#(erantara# terutama o$eh serabut a**eren Cyan' ter$eta" d#d#nd#n' ron''a -#sera$ dan d# "a(su$ or'an "eras, T#da" se(ert# nyer# somat#s/

nyer# -#sera$ d#t#mbu$"an o$eh (ere'an'an/ #n*$amas# atau #s"em# yan' menst#mu$as# rese(tor

sara*/ atau "eter$#batan $an'sun' sara* sensor# contohnya/ #n*#$tras# dar# ma$#'na9, Pusat(ener#ma ran'san'an umumnya $ama untu" men#mbu$"an/ tum(u$/ "uran' $o"a$#sas# dan

mem(er(an+an', Perbedaan stru"tur -#scera$ yan' berhubun'an den'an t#n'"at sensor#s yan'

berbeda (ada tu$an' be$a"an', Karena ha$ #n#/ (en#n'"atan "ete'an'an d#nd#n' d#sebab"an

d#stens# $umen atau "ontra"s# otot (o$os "o$#"9 yan' men'has#$"an nyer# d#*us +u'a da$amd#ten'ah e(#'astr#um/ (er#umb#$#"a$/ abdomen ba0ah/ atau *$an" area, Nyer# -#sera $eb#h ser#n'

d#rasa"an d#'ar#s ten'ah "arena "edua sara* sensor#s a"an menu+u tu$an' be$a"an',

Seba$#"nya/ nyer# (ar#eta$ yan' d#med#as# o$eh serat ner-us c dan A de$ta yan' bertan''un'+a0ab untu" (enyam(a#an sensas# yan' $eb#h a"ut/ ta+am dan $o"a$#sas# nyer#, Peran'san'an

$an'sun' somat#c dar# (er#toneum (ar#eta$ terutama ba'#an anter#or dan su(er#or9 o$eh ca#ran

(us/ em(edu/ ur#n/ 'astro #ntest#na$ menyebab"an nyer# $oca$ yan' $eb#h te(at, Penyebaran nyer#(ar#eta$ berdasar"an T.)!1, Nyer# (ar#eta$ $eb#h mudah ter$o"a$#s#sr dar#(ada nyer# -#scera$

"arena serat a*eren somat#c hanya tertu+u (ada satu s#s# dar# system sara*, Nyer# (ar#eta$ abdomen

secara umum d#'ambar"an ter+ad# (ada em(at "uadran dar# abdomen,Nyer# abdomen mun'"#n d#a$#h"an atau ber'eser +auh dar# tem(at or'an sa"#t, Ist#$ah nyer# a$#h

menanda"an sensas# yan' d#rasa"an berasa$ dar# st#mu$us utama yan' +auh, 7asa yan' ber$eb#han

dar# tem(at nyer# d#"arena"an (en'aruh sara* a*eren dar# area $uas yan' ber$a#nan da$am(oster#or horn dar# medu$$a s(#na$#s, Contohnya/ nyer# yan' d#sebab"an (ada #r#tas# subd#a*ra'ma

o$eh udara/ ca#ran (er#toneum/ darah/ atau masa: d#a$#h"an "ebahu o$eh (erantara ner-us C)3

(hren#c9, Nyer# +u'a mun'"#n d#a$#h"an "ebahu dar# $es# su(ra d#a*ra'ma se(ert# (neumon#a

(ada $obus ba0ah (aru/ terutama (ada (as#en muda/ 0a$au(un $eb#h ser#n' terasa d#re'#o sca(u$a"anan/ nyer# a$#h em(edu mun'"#n m#r#( se(ert# an'#na (ector#s +#"a terasa d# thora"s anter#or

atau bahu "#r#, Nyer# (ostero$atera$ r#'ht *$an" ter$#hat (ada a((end#c#t#s retroceca$,


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Structures Ner-ous System Path0ays Sensory !e-e$

!#-er/ S($een/ dan ba'#an ten'ah d#a*ra'ma Ner-us Phren#"us C2)4

;a'#an (er#*er d#a*ra'ma/ !ambun'/ Pan"reas/ Ga$$b$ader/ sus Ha$us Ner-us S(h$an#"usMayor dan P$e


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t#n'"at $es#, muntah ca#ran em(edu beru$an')bernoda ada$ah tanda a0a$ "has obstru"s# (ro"s#ma$

usus "ec#$, Pada obstru"s# usus d#sta$ "ec#$ atau besar/ $ama mendahu$u# mua$ muntah/ yan'

mun'"#n men+ad# "eruh da$am "asus)"asus ter$ambat, Gan''uan yan' menyebab"an muntah(ada (as#en yan' $eb#h muda mun'"#n hanya men#mbu$"an anore"s#a atau mua$ (ada (as#en

yan' $eb#h tua, Mes"#(un muntah da(at had#r da$am ba#" a(end#s#t#s a"ut atau sa"#t (erut

s(es#*#"/ h#du( bersama mua$ dan anore"s#a $eb#h su'est#* "ond#s# be"as,

;, Konst#(as#7e*$e< #$eus ser#n' d#sebab"an o$eh serat a*eren -#scera$ meran'san' serat e*eren dar# s#stem

sara* otonom s#m(at#" sara* s($an"n#"9 untu" men'uran'# 'era" (er#sta$t#" usus, O$eh "arena

#tu/ #$eus (ara$#t#" merendah"an n#$a# sembe$#t da$am d#a'nos#s d#*erens#a$ dar# (erut a"ut,Sembe$#t #tu send#r# ada$ah t#da" mut$a" #nd#"ator obstru"s# usus, Namun/ "esu$#tan membuan'

a#r besar t#da" adanya ba'#an dar# "edua ban'"u dan "entut9 san'at menyaran"an obstru"s# usus

me"an#" +#"a ada d#stens# (erut (ro'res#* menya"#t"an atau muntah beru$an')u$an',

C, D#are

NTK !E;IH !ENGKAPNBA ;ISA DI !IHAT DI herryyudha,b$o's(ot/com

D#tu$#s da$am ncate'or#ed

T#n''a$"an Sebuah Komentar

Ka#t"ata a"ut abdomen/ a((end#c#r#ton#t#st#s/ d#a'nosa/nyer#/(e

LAKA BAKAR AKIBAT LISTRIK

Mar 1.

Posted by herrysyu

CEDE7A !IST7IK

C#dera $#str#" ser#n' d#da(at"an (ada (ra"te" sehar# har# dan (asen a"an datan' "e emer'ency,

+en#s cedera $#str#" terd#r# dar# t#'a macam ya#tu cedera arus $#str#"/ $u"a ba"ar e$ectrotherma$dar# (encetusan saat #n#/ dan $u"a ba"ar yan' d#sebab"an o$eh (enya$aan a(# (a"a#an, Kadan')

"adan'/ "et#'a a"an had#r da$am "orban yan' sama,

$ash atau $u"a ba"ar $#str#" ada$ah cedera (anas untu" "u$#t yan' d#sebab"an o$eh te'an'ant#n''# arus $#str#" menca(a# "u$#t dar# "ondu"tor, !u"a (anas untu" "u$#t yan' #ntens dan

menda$am/ "arena arus $#str#" mem#$#"# suhu se"#tar 4>>FC cu"u( t#n''# untu" me$e$eh"an

tu$an'9, A(# memba"ar (a"a#an dar# ser#n' mem#cu ba'#an (a$#n' ser#us dar# cedera, Pera0atan$u"anya sama se(ert# untu" set#a( cedera terma$,

A"#bat Kerusa"an dar# arus $#str#" secara $an'sun' (ro(ors#ona$ terhada( #ntens#tas seba'a#

d#atur o$eh hu"um Ohm, Den'an dem#"#an/ arus $#str#" ter'antun' (ada te'an'an dan (er$a0anan

yan' d#ber#"an o$eh berba'a# ba'#an tubuh, Te'an'an d# atas 3> 5 d#an''a( berbahaya,
http://herrysetyayudha.wordpress.com/category/uncategorized/http://herrysetyayudha.wordpress.com/2012/03/18/pendekatan-diagnostik-akut-abdomen-6/#respondhttp://herrysetyayudha.wordpress.com/tag/akut-abdomen/http://herrysetyayudha.wordpress.com/tag/appendiciritonitistis/http://herrysetyayudha.wordpress.com/tag/diagnosa/http://herrysetyayudha.wordpress.com/tag/nyeri/http://herrysetyayudha.wordpress.com/tag/nyeri/http://herrysetyayudha.wordpress.com/tag/nyeri/http://herrysetyayudha.wordpress.com/tag/pe/http://herrysetyayudha.wordpress.com/2012/03/16/laka-bakar-akibat-listrik/http://herrysetyayudha.wordpress.com/2012/03/16/laka-bakar-akibat-listrik/http://herrysetyayudha.wordpress.com/author/herrysyu/http://herrysetyayudha.wordpress.com/category/uncategorized/http://herrysetyayudha.wordpress.com/2012/03/18/pendekatan-diagnostik-akut-abdomen-6/#respondhttp://herrysetyayudha.wordpress.com/tag/akut-abdomen/http://herrysetyayudha.wordpress.com/tag/appendiciritonitistis/http://herrysetyayudha.wordpress.com/tag/diagnosa/http://herrysetyayudha.wordpress.com/tag/nyeri/http://herrysetyayudha.wordpress.com/tag/pe/http://herrysetyayudha.wordpress.com/2012/03/16/laka-bakar-akibat-listrik/http://herrysetyayudha.wordpress.com/2012/03/16/laka-bakar-akibat-listrik/http://herrysetyayudha.wordpress.com/author/herrysyu/


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Sete$ah saat #n# te$ah memasu"# tubuh/ +a$ur ber'antun' (ada res#stens# #tu (ertemuan da$am

berba'a# or'an, ;er#"ut #n# ada$ah tercantum da$am urutan res#stens# tu$an'/ $ema"/ urat/ "u$#t/

otot/ darah/ dan sara*, a$ur dar# menentu"an saat #n# bertahan h#du(/ m#sa$nya/ +#"a sedan'me$e0at# +antun' atau batan' ota"/ "emat#an da(at $an'sun' dar# *#br#$as# -entr#"e$ atau a(nea,

!ancar $e0at me$a$u# da(at menyebab"an "e+an' otot cu"u( (arah untu" men'has#$"an (atah

tu$an')tu$an' (an+an' atau d#s$o"as#,en#s saat #n# +u'a ter"a#t den'an t#n'"at "e(arahan cedera, s#"$us arus bo$a" ba$#" yan'

menyebab"an cedera (a$#n' (arah,

CEDE7A saat tersen'at $#str#" $eb#h dar# se"edar $u"a ba"ar, o"a$ $u"a ba"ar ter+ad# (ada t#t#"masu" dan "e$uar me$a$u# "u$#t, ;e'#tu berada d# da$am tubuh/ (er+a$anan saat #n# me$a$u# otot/

menyebab"an cedera $eb#h se(ert# hancur dar#(ada $u"a ba"ar terma$, Trombos#s ser#n' ter+ad# d#

"a(a$ +auh d# u+un' sebuah/ menyebab"an "eda$aman ne"ros#s +ar#n'an yan' $eb#h besar dar#(ada

yan' ter$#hat (ada (emer#"saan a0a$, Cedera otot terbesar b#asanya (a$#n' de"at den'an tu$an'/d#mana (anas tert#n''# (er$a0anan d#has#$"an, Pen'obatan cedera $#str#" ter'antun' (ada $uasnya

otot da$am dan sara* "ehancuran $eb#h dar# *a"tor)*a"tor $a#nnya,

Ter+ad#nya Myo'$ob#nur#a da(at ber"emban' den'an r#s#"o tubu$ar ne"ros#s a"ut, Out(ut ur#n

harus se$a$u dua sam(a# t#'a "a$# norma$ den'an ca#ran #ntra-ena, A$"a$#n#at#on dar# ur#n dand#uret#" osmot#" da(at d##nd#"as#"an +#"a terda(at myo'$ob#nur#a ,

Adanya Penurunan hemato"r#t ce(at t#ba)t#ba "adan')"adan' ber#"ut (en'hancuran se$ darahmerah o$eh ener'# $#str#", Perdarahan "e da$am +ar#n'an da(at ter+ad# seba'a# a"#bat 'an''uan

(embu$uh darah dan (esa0at +ar#n'an, Da$am bebera(a "asus/ "a(a$ thrombosed hancur

"emud#an dan menyebab"an (erdarahan besar #nterst#s#a$,!u"a tem(at "u$#t terba"ar d# (#ntu masu" dan "e$uar b#asanya de(res# 0#$ayah abu)abu atau

"un#n' men'h#$an'"an "eteba$an derm#s serta d#"e$#$#n'# o$eh ona ta+am h#(erem#a d#tentu"an,

Charr#n' mun'"#n had#r +#"a memba"ar busur berdam(#n'an, !es# harus d#debr#dement untu"

mendasar# +ar#n'an sehat, Ser#n' ada da$am (en'hancuran a0a$nya t#da" +e$as, ar#n'an yan'mat# dan de-#ta$#ed #n# +u'a harus d#e"s#s#,

Sebuah debr#demen u$an' b#asanya menun+u""an 0a"tu 3)38 +am sete$ah cedera/ "arena

ne"ros#s d#temu"an $eb#h $uas dar#(ada yan' d#(er"#ra"an, Strate'# untu" menda(at"an "u$#tyan' me$#(ut# $u"a ba"ar #n# ter'antun' $uas dan "eda$aman $u"a)$u"a, *$a(s m#"ro-as"u$er

se"aran' d#'una"an secara rut#n untu" men''ant# "eh#$an'an +ar#n'an yan' besar,

Penan'anan Secara umum/ (en'obatan cedera $#str#" yan' "om($e"s d# set#a( $an'"ah/ dansete$ah resus#tas# a0a$ (as#en #n# harus d#ru+u" "e (usat)(usat "husus ? burn centre,



SENGATAN PANAS (HEAT STROKE)

DAN PENGANANANNYA.

Mar 1.
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7/32

Posted by herrysyu

HEAT ST7OKE

"et#"a suhu tubuh me$eb#h# 3> F C ma"a "eadaan heat stro"e a"an ter+ad# dan a"an tr+ad#d#s*un's# s#stem sara* (usat yan' (arah, Dua "eadaan ter"a#t $a#nnya yan' d#sebab"an o$eh

(a(aran (anas ada$ah (anas "ram dan "e$e$ahan,D# ne'ara ne'ara 'urun den'an a"t#*#tas *#s#" d# outdoor ser#n' ter+ad# "asus #n#, Saat +emaah ha+#

bera"t#*#tas d# tem(at yerbu"a, Keadaan Heat cram(s (anas nyer# otot sete$ah tena'a da$am$#n'"un'an)(anas b#asanya ser#n' berhubun'an den'an de*#s#t 'aram, contoh se(ert#

rhabdomyo$ys#s e F C rentan' 3>)32 F C9/ d#a'nos#s heat stro"e

de*#n#t#*, Pen'u"uran suhu tubuh harus d#$a"u"an dubur, Sebuah (rodrome termasu" (us#n'/

sa"#t "e(a$a/ mua$/ men''#'#$/ dan mer#nd#n' dar# dada dan $en'an ter$#hat sese"a$# ta(# t#da"umum, Da$am "ebanya"an "asus/ (as#en #n'at sete$ah men'a$am# 'e+a$a (er#n'atan "ecua$#

"e$emahan/ "e$e$ahan/ atau (us#n', Keb#n'un'an/ (er#$a"u a'res#*/ atau (#n'san b#sa mendahu$u#

"oma, Ke+an' da(at ter+ad# sete$ah masu" "e rumah sa"#t,Ku$#t merah muda atau (ucat dan "adan')"adan'/ anehnya/ "er#n' dan (anas/ "u$#t "er#n' d#
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hada(an hy(er(yre?m#n: te"anan ba+# -ena sentra$ atau (aru t#n''#/ dan da$am bebera(a "asus te"anan darahrendah, H#(er-ent#$as# da(at menca(a# .>?m#n dan da(at men#mbu$"an a$"a$os#s (erna*asan,

edema (aru dan daha" berdarah da(at men'emban'"an da$am "asus)"asus yan' (arah, Penya"#t

"un#n' ser#n' da$am bebera(a har# (ertama sete$ah onset 'e+a$a,Deh#dras#/ yan' da(at men'has#$"an s#stem yan' sama 'e+a$a sara* (usat se(ert# stro"e (anas/

meru(a"an *a"tor men+en'"e$"an d# se"#tar 14 dar# "asus,

;, !aborator#umT#da" ada (o$a "ara"ter#st#" den'an (erubahan e$e"tro$#t Konsentras# natr#um serum mun'"#n

norma$ atau t#n''#/ dan "onsentras# "a$#um b#asanya rendah (ada (en'a"uan atau d# bebera(a

t#t#" se$ama resus#tas#, H#(o"a$sem#a umum/ dan h#(o*os*atem#a da(at ter+ad#, Da$am bebera(a

har# (ertama/ AST/ !DH/ dan mun'"#n CK men#n'"at/ terutama (ada stro"e e


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dan membuat (emantauan (as#en $eb#h su$#t, Memon#tor suhu re"tum ser#n', ntu" men'h#ndar#

o-ershoot#n' t#t#" a"h#r/ (end#n'#nan "uat harus d#hent#"an saat suhu menca(a# 28/= F C,

Men''#'#$ harus d#"ontro$ den'an *enot#a#n (arentera$, O"s#'en harus d#ber#"an/ dan +#"a turunPaO d# ba0ah .4 mm H'/ #ntubas# tra"ea harus d#$a"u"an untu" men'ontro$ -ent#$as#, Ca#ran/

e$e"tro$#t/ dan "ese#mban'an asam)basa harus d#"ontro$ den'an memon#tor ser#n', Ca#ran

#ntra-ena adm#n#stras# harus d#dasar"an (ada te"anan arter# -ena sentra$ atau (u$monary 0ed'e/te"anan darah/ dan out(ut ur#n: o-erhydrat#on harus d#h#ndar#, 7ata)rata/ se"#tar 13>> m! ca#ran

d#(er$u"an da$am 3 +am (ertama resus#tas#, Intra-ena man#to$ 1/4 '9 da(at d#ber#"an a0a$ +#"a

myo'$ob#nur#a had#r, Ga'a$ '#n+a$ mun'"#n memer$u"an hemod#a$#s#s, "oa'u$as# #ntra-ascu$ard#ssem#nated mun'"#n memer$u"an (en'obatan den'an he(ar#n, D#'#ta$#s dan a'en "adan')

"adan' #notro(#c m#sa$nya/ #so(rotereno$/ do(am#n9 da(at d##nd#"as#"an untu" #nsu*#s#ens#

+antun'/ yan' harus d#cur#'a# +#"a h#(otens# meneta( sete$ah h#(o-o$em#a te$ah d#(erba#"#,

Pro'nos#s(ro'nos#s buru" b#$a suhu tubuh 3/FC atau $eb#h/ "oma ber$an'sun' $eb#h dar# +am/ shoc"/

h#(er"a$em#a/ dan AST $eb#h dar# 1>>> un#t?! se$ama 3 +am (ertama, T#n'"at "emat#an ada$ah

se"#tar 1> (ada (as#en yan' d#d#a'nos#s den'an benar dan se'era d#obat#, Kemat#an da$am

bebera(a har# (ertama b#asanya "arena "erusa"an ota": Kemat#an datan' mun'"#n dar#(endarahan atau mun'"#n "arena +antun'/ '#n+a$/ atau "e'a'a$an hat#,



cidera luka akar li!"rik

Mar 1>

Posted by herrysyu

#EDERA LISTRIK

C#dera $#str#" ser#n' d#da(at"an (ada (ra"te" sehar# har# dan (asen a"an datan' "e emer'ency,

+en#s cedera $#str#" terd#r# dar# t#'a macam ya#tu cedera arus $#str#"/ $u"a ba"ar e$ectrotherma$dar# (encetusan saat #n#/ dan $u"a ba"ar yan' d#sebab"an o$eh (enya$aan a(# (a"a#an, Kadan')

"adan'/ "et#'a a"an had#r da$am "orban yan' sama,

$ash atau $u"a ba"ar $#str#" ada$ah cedera (anas untu" "u$#t yan' d#sebab"an o$eh te'an'an

t#n''# arus $#str#" menca(a# "u$#t dar# "ondu"tor, !u"a (anas untu" "u$#t yan' #ntens dan

menda$am/ "arena arus $#str#" mem#$#"# suhu se"#tar 4>>FC cu"u( t#n''# untu" me$e$eh"antu$an'9, A(# memba"ar (a"a#an dar# ser#n' mem#cu ba'#an (a$#n' ser#us dar# cedera, Pera0atan

$u"anya sama se(ert# untu" set#a( cedera terma$,

A"#bat Kerusa"an dar# arus $#str#" secara $an'sun' (ro(ors#ona$ terhada( #ntens#tas seba'a#d#atur o$eh hu"um Ohm, Den'an dem#"#an/ arus $#str#" ter'antun' (ada te'an'an dan (er$a0anan

yan' d#ber#"an o$eh berba'a# ba'#an tubuh, Te'an'an d# atas 3> 5 d#an''a( berbahaya,
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10/32

Sete$ah saat #n# te$ah memasu"# tubuh/ +a$ur ber'antun' (ada res#stens# #tu (ertemuan da$am

berba'a# or'an, ;er#"ut #n# ada$ah tercantum da$am urutan res#stens# tu$an'/ $ema"/ urat/ "u$#t/

otot/ darah/ dan sara*, a$ur dar# menentu"an saat #n# bertahan h#du(/ m#sa$nya/ +#"a sedan'me$e0at# +antun' atau batan' ota"/ "emat#an da(at $an'sun' dar# *#br#$as# -entr#"e$ atau a(nea,

!ancar $e0at me$a$u# da(at menyebab"an "e+an' otot cu"u( (arah untu" men'has#$"an (atah

tu$an')tu$an' (an+an' atau d#s$o"as#,

en#s saat #n# +u'a ter"a#t den'an t#n'"at "e(arahan cedera, s#"$us arus bo$a" ba$#" yan'menyebab"an cedera (a$#n' (arah,

CEDE7A saat tersen'at $#str#" $eb#h dar# se"edar $u"a ba"ar, o"a$ $u"a ba"ar ter+ad# (ada t#t#"

masu" dan "e$uar me$a$u# "u$#t, ;e'#tu berada d# da$am tubuh/ (er+a$anan saat #n# me$a$u# otot/menyebab"an cedera $eb#h se(ert# hancur dar#(ada $u"a ba"ar terma$, Trombos#s ser#n' ter+ad# d#

"a(a$ +auh d# u+un' sebuah/ menyebab"an "eda$aman ne"ros#s +ar#n'an yan' $eb#h besar dar#(ada

yan' ter$#hat (ada (emer#"saan a0a$, Cedera otot terbesar b#asanya (a$#n' de"at den'an tu$an'/

d#mana (anas tert#n''# (er$a0anan d#has#$"an, Pen'obatan cedera $#str#" ter'antun' (ada $uasnya

otot da$am dan sara* "ehancuran $eb#h dar# *a"tor)*a"tor $a#nnya,

Ter+ad#nya Myo'$ob#nur#a da(at ber"emban' den'an r#s#"o tubu$ar ne"ros#s a"ut, Out(ut ur#n

harus se$a$u dua sam(a# t#'a "a$# norma$ den'an ca#ran #ntra-ena, A$"a$#n#at#on dar# ur#n dan

d#uret#" osmot#" da(at d##nd#"as#"an +#"a terda(at myo'$ob#nur#a ,

Adanya Penurunan hemato"r#t ce(at t#ba)t#ba "adan')"adan' ber#"ut (en'hancuran se$ darah

merah o$eh ener'# $#str#", Perdarahan "e da$am +ar#n'an da(at ter+ad# seba'a# a"#bat 'an''uan

(embu$uh darah dan (esa0at +ar#n'an, Da$am bebera(a "asus/ "a(a$ thrombosed hancur"emud#an dan menyebab"an (erdarahan besar #nterst#s#a$,

!u"a tem(at "u$#t terba"ar d# (#ntu masu" dan "e$uar b#asanya de(res# 0#$ayah abu)abu atau"un#n' men'h#$an'"an "eteba$an derm#s serta d#"e$#$#n'# o$eh ona ta+am h#(erem#a d#tentu"an,

Charr#n' mun'"#n had#r +#"a memba"ar busur berdam(#n'an, !es# harus d#debr#dement untu"mendasar# +ar#n'an sehat, Ser#n' ada da$am (en'hancuran a0a$nya t#da" +e$as, ar#n'an yan'

mat# dan de-#ta$#ed #n# +u'a harus d#e"s#s#,

Sebuah debr#demen u$an' b#asanya menun+u""an 0a"tu 3)38 +am sete$ah cedera/ "arena

ne"ros#s d#temu"an $eb#h $uas dar#(ada yan' d#(er"#ra"an, Strate'# untu" menda(at"an "u$#tyan' me$#(ut# $u"a ba"ar #n# ter'antun' $uas dan "eda$aman $u"a)$u"a, *$a(s m#"ro-as"u$er

se"aran' d#'una"an secara rut#n untu" men''ant# "eh#$an'an +ar#n'an yan' besar,

Penan'anan Secara umum/ (en'obatan cedera $#str#" yan' "om($e"s d# set#a( $an'"ah/ dansete$ah resus#tas# a0a$ (as#en #n# harus d#ru+u" "e (usat)(usat "husus ? burn centre,

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11/32


KETERAMPILAN DASAR TEHNIK BEDAH DENGAN

PENGETAHUAN MATERIAL SUTURE

eb =

Posted by herrysyu

KETERAMPILAN DASAR TEKHNIK BEDAH DAN PENGETAHUAN DASAR

MATERIAL SUTURE

BAB I

PENDAHULUAN

PENGETAHAN Pen+ah#tan $u"a d#(er$u"an da$am #$mu bedah "arena (embedahan membuat

$u"a sayatandan (en+ah#tan bertu+uan untu" menyatu"an "emba$# +ar#n'an yan' ter(utus sertamen#n'"at"an (roses (enyambun'an dan (enyembuhan +ar#n'an dan +u'a mence'ah $u"a

terbu"a yan' a"an men'a"#bat"an masu"nya m#"roor'an#sme ? #n*e"s#,

Mater#a$ (en+ah#tan yan' ber"ua$#atas ada$ah yan' me$#(ut# sarat)sarat tertentu, Ban' (ertama

ada$ah "enyamanan untu" d#'una"an atau untu" d#(e'an', !a$u (en'amanan yan' cu"u( (ada

set#a( a$at, Harus se$a$u ster#$, Cu"u( e$ast#", ;u"an terbuat dar# bahn yan' rea"t#*, Ke"uatanyan' cu"u( untu" (enyembuhan $u"a, Kemam(uan untu" b#ode'radas# "#m#a untu" menceah

(erusa"an dar# benda as#n',

BAB II

MATERIAL SUTURE

Pen''unaan a$at dan Mater#a$ (en+ah#tan yan' ber"ua$#atas ada$ah yan' me$#(ut# syarat)syarat

tertentu, Ban' (ertama ada$ah "enyamanan untu" d#'una"an atau untu" d#(e'an', !a$u(en'amanan yan' cu"u( (ada set#a( a$at, Harus se$a$u ster#$, Cu"u( e$ast#", ;u"an terbuat dar#

bahan yan' rea"t#*, Ke"uatan yan' cu"u( untu" (enyembuhan $u"a, Kemam(uan untu"

b#ode'radas# "#m#a untu" menceah (erusa"an dar# benda as#n',
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12/32

II.$. INSTRUMEN

$. Needle %&lder

Nama $a#nnya (eme'an' +arum atau na$d -oeder, en#s yan' d#'una"an ber-ar#as#/ ya#tu t#(e

Cr#$$e 0ood bentu"nya se(ert# "$em9 dan t#(e Mathe0 Kusten bentu" se'#t#'a9, Guna need$eho$der #n# (ada (en+ah#tan seba'a# (eme'an' +arum +ah#t dan seba'a# (eny#m(u$

benan',

Tipe Crille wood


13/32

Tipe Mathew Kusten

Needle Holder

'. Gu"i

Gunting Benang


14/32

Ada dua macam 'unt#n' benan' ya#tu 'unt#n' benan' yan' ben'"o" dan $urus yan'

"e'unaannya untu" memoton' benan' o(eras#/ mera(#"an $u"a, Penyed#aan mas#n')mas#n' satu

buah,

Gunting Diseksi

Gunt#n' #n# ada dua +en#s/ ya#tu $urus dan ben'"o", +un'nya b#asanya runc#n', Terda(at duayan' ser#n' d#'una"an/ ya#tu t#(e Mayo dan t#(e Metenbaum, Ke'unaan 'unt#n' #n# ada$ah

untu" membu"a +ar#n'an/ membebas"an tumor "ec#$ dar# +ar#n'an se"#tarnya/ untu" es"s($oras#

dan mera(#"an $u"a,

dissecting scissors


15/32

Gunting perban/pembalut

Ke'unaan ada$ah untu" men''unt#n' (emba$ut dan ($ester,


16/32

*. Pi!au Beda%

Terd#r# atas dua ba'#an ya#tu 'a'an' dan mata (#sau mess?b#stour#?b$ade9, Pada (#sau bedah

mode$ $ama/ mata (#sau dan 'a'an' bersatu/ seh#n''a b#$a mata (#sau tum(u$ harus d#asah"emba$#, Pada mode$ baru/ mata (#sau da(at d#'ant#, ;#asanya mata (#sau hanya untu" se"a$#

(a"a#,

Terda(at dua nomor 'a'an' (#sau yan' ser#n' d#(a"a#/ ya#tu 'a'an' nomor 3 untu" mata

(#sau besar9 dan 'a'an' nomor 2 untu" mata (#sau "ec#$9, Guna (#sau bedah #n# ada$ah untu"menyayat berba'a# or'an ?ba'#an tubuh, Mata (#sau d#sesua#"an den'an ba'#an tubuh yan' a"an

d#sayat,


17/32

+. Kle, (#la,-)

Klem arteri pean, Ada dua +en#s/ ya#tu yan' $urus dan ben'"o", Ke'unaannya ada$ah untu"

hemostas#s terutama untu" +ar#n'an t#(#s dan $una",

Klem Kocher, Ada dua +en#s ya#tu "$em yan' $urus dan yan' ben'"o", T#da" d#tu+u"an untu"

hemostas#s, S#*at "hasnya ada$ah mem(unya# '#'# (ada u+un'nya m#r#( '#'# (ada (#nsets#rur'#s9, Gunanya ada$ah untu" men+e(#t +ar#n'an/ terutama a'ar +ar#n'an t#da" me$eset dar#

"$em/ dan ha$ #n# d#mun'"#n"an den'an adanya '#'# (ada u+un' "$em,


18/32

Klem Mosquito, M#r#( den'an "$em arter# (ean/ teta(# u"uranya $eb#h "ec#$, Pen''unaannya

da$ah untu" hemostas#s terutama untu" +ar#n'an t#(#s dan $una",

Klem llis, Pen''unaannya ada$ah untu" men+e(#t +ar#n'an yan' ha$us dan men+e(#t tumor

"ec#$,


19/32

Klem Babcock, Pen''unaanya ada$ah untu" men+e(#t tumor yan' a'a" besar dan ra(uh,

Towel clamp !Doek klem", Pen''unaanya ada$ah untu" men+e(#t doe"?"a#n o(eras#,


20/32

. Re"rak"&r (/&ud H&&k)

#etraktor langenbeck$ Pen''unaannya ada$ah men'ua""an $u"a,

%& arm' double ended retractor$Pen''unaannya untu" men'ua""an $u"a,

#etraktor (olkman$Pen''unaannya ada$ah untu" men'ua""an $u"a, Pema"a#an retractor

d#sesua#"an den'an $ebar $u"a, Ada yan' mem(unya# dua '#'#/ 2 '#'#/ dan 3 '#'#, '#'# untu"$u"a "ec#$/ 3 '#'# untu" $u"a besar, Terda(at (u$a retractor ber'#'# tum(u$,

0. 1aru,

;anya" se"a$# +en#snya, ntu" men+ah#t "u$#t d#'una"an yan' ber(enam(a" se'#t#'a a'ar

mudah men'#r#s "u$#t scher(e na$d9, Sedan' untu" men+ah#t otot d#(a"a# yan' ber(enam(an'bu$at round na$d9, Ada yan' berbentu" seten'ah $#n'"aran dan ada (u$a yan' berbentu"

se(erem(at $#n'"aran,


21/32

Pen''unaannya ada$ah untu" men+ah#t $u"a dan men+ah#t ora'n rusa" $a#nnya, Penyed#aan

d#sesua#"an "ebutuhan,

2. Pi!e"

)inset sirurgis, Pen''unaanya ada$ah untu" men+e(#t +ar#n'an (ada 0a"tu d#se"s# dan

(en+ah#tan $u"a/ member tanda (ada "u$#t sebe$um memu$a# #ns#s#,

)inset anatomis, Pen''unaanya ada$ah untu" men+e(#t "asa se0a"tu mene"an $u"a/ men+e(#t

+ar#n'an yan' t#(#s dan $una",


22/32

3. Bea

&eide/ silk

Terbuat dar# serabut)serabut sutera/ terd#r# dar# 6> serabut (rote#n dan 2> bahan tambahan

beru(a (ere"at, arnanya h#tam dan (ut#h, ;ers#*at t#da" $#c#n se(ert# sutera b#asa "arena sudahd#"omb#nas# den'an (ere"at, T#da" d#sera( tubuh, Pada (en''unaan d# sebe$ah $uar ma"a benan'harus d#bu"a "emba$#,

Tersed#a da$am berba'a# u"uran/ mu$a# dar# nomor >>>>> 4 no$ meru(a"an u"uran (a$#n' "ec#$

untu" ba' bedah9 h#n''a nomor 2 yan' meru(a"an u"uran (a$#n' besar9, Ban' (a$#n' ser#n'd#(a"a# ada$ah nomor >> no$9 dan > 1 no$9 dan nomor satu, Sema"#n besar banya" no$ nya

sema"#n "ec#$ benan'nya

Ke'unaannya ada$ah untu" men+ah#t "u$#t/ men'#"at (embu$uh arter# terutama arter# besar9/

seba'a# teu'e$ "enda$#9,

;enan' harus ster#$/ sebab b#$a t#da" a"an men+ad# saran' "uman *o"us #n*e"s#9/ sebeb "umanter$#ndun' d# da$am +ah#tan benan'/ sedan' benan'nya send#r# t#da" da(at d#sera( tubuh,

)lain catgut

Asa$ "atanya ada$ah cat "uc#n'9 dan 'ut usus9, Dahu$u benan' #n# d#buat dar# usus "uc#n'/ ta(#

saat #n# d#buat dar# usus domba atau usus sa(#, ;ers#*at da(at d#sera( o$eh tubuh/ (enyera(an

ber$an'sun' da$am 0a"tu 6)1> har#/ dan 0arnanya (ut#h dan "e"un#n'an,

Tersed#a da$am berba'a# u"uran/ mu$a# dar# >>>>> 4 no$ yan' meru(a"an u"uran (a$#n' "ec#$9h#n''a nomor 2 meru(a"n u"uran yan' terbesar9, Ser#n' d#'una"an nomor >>> 2 no$9/ >>

no$9/ > 1 no$9/ nomor 1 dan nomor ,

Ke'unaannya ada$ah untu" men'#"at sumber (erdarahan "ec#$/ men+ah#t sub"ut#s dan da(at (u$a

d#(er'una"an untu" men+ah#t "u$#t terutama untu" daerah $on''ar (erut/0a+ah9 yan' ta" banya"ber'era" dan $uas $u"anya "ec#$,

P$a#n cat'ut harus d#s#m(u$ (a$#n' sed#"#t 2 "a$#/ "arena da$am tubuh a"an men'emban'/ b#$a

d#s#m(u$"an "a$# a"an terbu"a "emba$#, P$a#n cat'ut t#da" bo$eh terendam da$am $#so$ "arena

a"an men'emban' dan men+ad# $una"/ seh#n''a t#da" da(at d#'una"an,

Chromic catgut

;erbeda den'an ($a#n cat'ut/ sebe$um benan' d#(#nta$ d#tambah"an "rom, Den'an adanya "rom

#n#/ ma"a benan' a"n men+ad# $eb#h "eras dan "uat/ serta (enyera(annnya $eb#h $ama/ ya#tu >)

3> har#, arnanya co"$at dan "eb#ruan, ;enan' #n# tersed#a da$am u"uran >>> 2 no$ meru(a"an

u"uran yan' (a$#n' "ec#$9 h#n''a nomor 2,


23/32

Pen''unaannya (ada (en+ah#tan $u"a yan' d#an''a( be$um mera(at da$am 0a"tu se(u$uh har#/

untu" men+ah#t tendo (ada (ender#ta yan' t#da" "oo(erat#* dan b#$a mob#$#sas# harus se'era

d#$a"u"an,

Nilon$ !Da*ilon+monoso*+dermalon,thilon"

Meru(a"an benan' s#ntet#s da$am "emasan atraumat#s benan' $an'sun' bersatu den'an +arum+ah#t9 dan terbuat dar# n#$on/ $eboh "uat dar# se#de atau cat'ut, T#da" d#sera( tubuh/ dan t#da"

men#mb#$"an #r#tas# (ada "u$#t atau +ar#n'an tubuh $a#nnya,

arnanya b#ru h#tam, Tersed#a da$am u"uran 1> no$ h#n''a 1 no$, Pen''unanan (ada bedah($ast#"/ u"uran yan' $eb#h besar ser#n' d#'una"an "u$#t/ nomor yan' "ec#$ d#(a"a# (ada bedah

mata,

,thibond

Meru(a"an benan' s#ntet#s terbuat dar# (o$ytetra methy$ene ad#(ate9, Tersed#a da$am "emasanatraumat#s, ;ers#*at $embut/ "uat/ rea"s# terhada( tubuh m#numum/ t#da" d#sera(/ dan 0arnanya

h#+au dan (ut#h, "urannya dar# 6 no$ sam(a# nomor , Pen''unaannya (ada bedah"ard#o-as"u$ar dan uro$o'#,

-italene/)rolene/surgilen

Meru(a"an benan' s#ntet#s terbuat dar# (o$#mer (ro*#$en9, San'at "uat dan $embut/ t#da" d#sera(/

0arna b#ru, Tersed#a da$am "emasan atraumat#s, "uran dar# 1> no$ h#n''a nomor 1, D#'una"an

(ada bedah m#"ro/ terutama untu" (embu$uh darah dan +antun'/ bedah mata/ bedah ($ast#"/coco" (u$a untu" men+ah#t "u$#t,

).0 G0C.0C C0D &,),#T0 ).0&.#B+De1on+-icr'l

Meru(a"an benan' s#ntet#s da$am "emasan atraumat#s, D#sera( o$eh tubuh/ dan t#da"men#mbu$"an rea"s# (ada +ar#n'an tubuh, Da$am sub"ut#s bertahan se$am t#'a m#n''u/ da$am

otot bertahan se$am 2 bu$an, ;enan' #n# san'at $embut dan 0arnanya un'u,

"uran dar# 1> no$ h#n''a nomor 1, Pen''unaan (ada bedah mata/ ortho(ed#/ uro$o'# dan bedah

($ast#",

&upramid

Meru(a"an benan' s#ntet#s/ da$am "emasan atraumat#s, ;erds#*at "uat/ $embut *$e"s#be$/ rea"s#

tubu m#n#mum dan t#da" d#sera(, arnanya h#tam (ut#h, D#'una"an untu" men+ah#t "ut#s dan

sub"ut#s,

inen !catoon"


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D#buat den'an serat "a(as a$am den'an +a$an (em#nta$an, ;ers#*at $embut/ cu"u( "uat dan

mudah d#s#m(u$/ t#da" d#sera(/ rea"s# tubuh m#n#mum/ ber0arna (ut#h,

Tersed#a da$am u"uran 3 no$ h#n''a 1 no$, D#'una"an untu" men+ah#t usus dan "u$#t/ terutama"u$#t 0a+ah,

&teel wire

Meru(a"an benan' $o'am yan' terbuat dar# (o$#*#$amen ba+a tahn "arat, San'at "uat/ t#da"

"oros#*/ dan rea"s# terhada( tubuh m#n#mum, Mudah d#s#m(u$, arna (ut#h meta$#", Terda(at

da$am "emasan atraumat#s dan "emasan b#asa, "urannya dar# . no$ h#n''a nomor , ntu"men+ah#t tendon,

BAB III

TEKNIK SUTURE

III.$. TU1UAN

Dasar (en+ah#tan $u"a ada$ah membuat te"anan yan' ade"uat (ada $u"a a'ar tertutu( tan(a +ara"namun +u'a cu"u( $on''ar untu" men'h#ndar# #s"em#a dan ne"ros#s, ah#tan +u'a da(at bertu+uan

untu" mera0at hemostas#s atau (erdarahan yan' ter+ad#, Da(at men+ad# t#nda"an untu"

(eryo$on'an (ertama, Men'uran'# rasa sa"#t (ost o(erat#*, ah#tan +u'a meru(a"an (embuat

batasan #"atan (ada +ar#n'an sam(a# den'an sembuh dan t#da" $a'# d#butuh"an, ahtan +u'ada(at mence'ah tu$an' yan' mun'"#n tere"s(os (ada (enyembuhan $u"a yan' $ama dan resor(s#

yan' t#da" d#(er$u"an, Ha$ yan' +u'a (er$u d#$a"u"an (ada t#nda"an *$a(,

III.'. PRINSIP SUTURE

S#m(u$ $en'"a( harus "encan'/ dan "uat seh#n''a t#da" a"an ter$e(as, ntu" men'h#ndar#

#n*e"s# ba"ter#/ s#m(u$ d#$eta"an (ada 'ar#s #ns#s#, S#m(u$ harusnya d#buat "ec#$, an'an

men'#a"t ter$a$u "encan' untu" men'h#ndar# "erusa"an benan', an'an me$a"u"an banya"

'era"an yan' a"an merusa" +ah#tan, H#ndar# merusa" mater# hect#n' den'an men+e(#tmen''una"an need$e ho$der "ecua$# (ada saat a"an men'#"at, an'an ter$a$u "auat d#ata"ut"an

ter+ad# ne"ros#s, Tra"s# harus ade"uat,

III.*. MA#AM4MA#AM 1AHITAH


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1, Jahitan terputus

Terbanya" d#'una"an "arena sederhana dan mudah, T#a( +ah#tan d#s#m(u$ send#r#, Da(at

d#$a"u"an (ad a"u$#t atau ba'#an tubuh $a#nnya/ dan coco" untu" daerah yan' banya" ber'era""arean t#a( +ah#tan sa$#n' menun+an' satu den'an $a#nnya,

ah#tan ter(utus #nteru(ted suture9/ t#a()t#a( s#m(u$ berd#r# send#r#, Secara "osmet#" benan'

"asar?besar atau te'an' (ada saat meny#m(u$nya a"an member#"an be"as yan' "uran' ba'us/

ya#tu se(rt# 'ambaran $#(an,

2. Jahitan simpul tunggal

S#non#m ah#tan Ter(utus Sederhana/ S#m($e Inerru(ted Suture. Meru(a"an +en#s +ah#tan yan'

ser#n' d#(a"a#, d#'una"an +u'a untu" +ah#tan s#tuas#,

Te"n#"

Me$a"u"an (enusu"an +arum den'an +ara" antara seten'ah sam(a# 1 cm d#te(# $u"a dan

se"a$#'us men'amb#$ +ar#n'an sub"utannya se"a$#an den'an menusu""an +arum secara te'a"$urus (ada atau searah 'ar#s $u"a,

S#m(u$ tun''a$ d#$a"u"an den'an benan' absorbab$e den'a +ara" antara 1cm,

S#m(u$ d# $eta""an d#te(# $u"a (ada sa$ah satu tem(at tusu"an

;enan' d#(oton' "uran' $eb#h 1 cm,

3. Jahitan matras Horizontal

S#non#m Hor#onta$ Mattress suture/ Interru(ted mattress

ah#tan den'an me$a"u"an (enusu"an se(ert# s#m(u$/ sebe$um d#s#m(u$ d#$an+ut"an den'an(enusu"an se+a+ar se+auh 1 cm dar# tusu"an (ertama,

Member#"an has#$ +ah#tan yan' "uat,


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4. Jahitan Matras Vertikal

S#non#m 5ert#ca$ Mattress suture/ Donat#/ Near to near and *ar to *ar

ah#tan den'an men+ah#t secara menda$am d#ba0ah $u"a "emud#an d#$an+ut"an den'an men+ah#tte(#)te(# $u"a, ;#asanya men'has#$"an (enyembuhan $u"a yan' ce(at "arena d# de"at"annya te(#)

te(# $u"a o$eh +ah#tan #n#,

5. Jahitan Matras Modifikasi

S#non#m Ha$* ;urr#ed Mattress Suture

Mod#*#"as# dar# matras hor#onta$ teta(# men+ah#t daerah $u"a seberan'nya (ada daerah

sub"utannya,


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., Jahitan kontinu

Ser#n' d#sebut door$o-en, S#m(u$ hanya (ada u+un')u+un' +ah#tan,/ +ad# hanya ada dua s#m(u$,

;#a$ sa$ah satu terbua" ma"a +ah#tan #n# a"an terbua" se$uruhnya, ah#tan #n# +aran' d#(a"a# untu"

men+ah#t "u$#t, Secar "osmet#" be"as $u"a +ah#tan se(ert# (ada +ah#tan ter(utus, ah#tan "ont#nuda(at d#$a"u"an $eb#h ce(at dar# +ah#tan ter(utus,


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7. Jahitan Jelujur sederhana

S#non#m S#m($e runn#n' suture/ S#m($e cont#nous/ Cont#nous o-er and o-er

ah#tan #n# san'at sederhana/ sama den'an "#ta men+e$u+ur ba+u, ;#asanya men'has#$"an has#e$

"osmet#" yan' ba#"/ t#da" d#saran"an (en''unaannya (ada +ar#n'an #"at yan' $on''ar,


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8. Jahitan Jelujur eston

S#non#m 7unn#n' $oc"ed suture/ Inter$oc"#n' suture

ah#tan "ont#nyu den'an men'a#t"an benan' (ada +ah#tan sebe$umnya/ b#asa ser#n' d#(a"a# (ada

+ah#tan (er#toneum, Meru(a"an -ar#as# +ah#tan +e$u+ur b#asa,

!. Jahitan Jelujur horizontal

S#non#m 7unn#n' Hor#onta$ suture

ah#tan "ont#nyu yan' d#se$#n'# den'an +ah#tan arah hor#onta$,

"#. Jahitan intradermal

Memeber#"an has#$ "osmet#" yan' (a$#n' ba'us hanya beru(a satu 'ar#s sa+a9, T#da"

da(at d#(a"a# untu" daerah yan' banya" ber'era", Pa$#n' ba#" untu" 0a+ah, Terda(at berba'a#

mod#*#"as# +ah#tan #ntraderma$ #n#, D#(er$u"an banya" $at#han untu" memah#r"an cara (en+ah#tan#ntraderma$ #n#,

"". Jahitan $impul %ntrakutan

S#non#m Subcutaneus Interu(ted suture/ Intraderma$ burr#ed suture/ Interru(ted derma$ st#tch,


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ah#tan s#m(u$ (ada daerah #ntra"utan/ b#asanya d#(a"a# untu" men+ah#t area yan' da$am

"emud#an (ada ba'#an $uarnya d#+ah#t (u$a den'an s#m(u$ sederhana,

"2. Jahitan Jelujur %ntrakutan

S#non#m 7unn#n' subcut#cu$ar suture/ ah#tan +e$u+ur sub"ut#"u$ar

ah#tan +e$u+ur yan' d#$a"u"an d#ba0ah "u$#t/ +ah#tan #n# ter"ena$ men'has#$"an "osmet#" yan'

ba#"

BAB I5

KESIMPULAN

Ma"erial !u"ure

Mater#a$ (en+ah#tan yan' ber"ua$#atas ada$ah yan' me$#(ut# sarat)sarat tertentu, Ban' (ertama

ada$ah "enyamanan untu" d#'una"an atau untu" d#(e'an', !a$u (en'amanan yan' cu"u( (adaset#a( a$at, Harus se$a$u ster#$, Cu"u( e$ast#", ;u"an terbuat dar# bahn yan' rea"t#*, Ke"uatan

yan' cu"u( untu" (enyembuhan $u"a, Kemam(uan untu" b#ode'radas# "#m#a untu" menceah(erusa"an dar# benda a Pen+ah#tan $u"a membutuh"an bebera(a (ers#a(an ba#" a$at/ bahan serta

bebera(a (era$atan $a#n, rutan te"n#" +u'a harus d#men'ert# o$eh o(erator serta as#stennya,

A$at yan' d#butuh"an

Naa$d 5oeder Need$e Ho$der 9 atau (eme'an' +arum b#asanya satu buah,

P#nset Ch#rrur'#s atau (#nset ;edah satu buah

Gunt#n' benan' satu buah,

arum +ah#t/ ter'antun' u"uran cu"u( dua buah sa+a,

;ahan yan' d#butuh"an

;enan' +ah#t Se#de atau s#$"

;enan' ah#t Cat 'ut chrom#c dan ($a#n,


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!a#n)$a#n

Doe" $uban' ster#$

Kasa ster#$

Handscoon ster#$

O(eras# te"n#"

rutan te"n#" (en+ah#tan $u"a suture techn#Jues9

1, Pers#a(an a$at dan bahan

, Pers#a(an as#sten dan o(erator

2, Des#n*e"s# $a(an'an o(eras#

3, Anestes# $a(an'an o(eras#

4, debr#dement dan e"s#s# te(# $u"a

., (en+ah#tan $u"a

6, (era0atan $u"a

Macam2macam 3ahitan luka

1, ah#tan S#m(u$ Tun''a$

, ah#tan matras Hor#onta$

2, ah#tan Matras 5ert#"a$

3, ah#tan Matras Mod#*#"as#

4, ah#tan e$u+ur sederhan

., ah#tan e$u+ur eston

6, ah#tan e$u+ur hor#onta$

8, ah#tan S#m(u$ Intra"utan


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=, ah#tan e$u+ur Intra"utan

DA6TAR PUSTAKA

1, Kara"ata S/ ;achs#nar ;, ;edah M#nor, 1==4, H#(o"rates a"arta

, Eth#con Inc/ ound C$osure Manua$, 1==3, ohnson and ohnson com(any

2, Doherty GM, Current&urgical Diagnosis and Treatment, SA McGra0 H#$$,>>.,

3, S+amsuh#da+at 7/ De on' #m,Buku 3ar 0lmu Bedah, Ed#s# "e), a"arta Penerb#t ;u"u

Kedo"teran EGC

4, 7e"so(rod+o S,Kumpulan Kuliah 0lmu Bedah, a"arta ;#naru(a A"sara, >>>,

., Mo"eem S, Sutures and Sutur#n', D#unduh tan''a$ = me# >1>, Tersed#a d#7! 000,scr#bd,com

6, 7em#e 7/ Kramer, Suture Mater#a$ and Techn#Jue, D#unduh tan''a$ = me# >1>, Tersed#a

d# 7!000,scr#bd,com

8, D0# A'un', Per0atan !u"a dan Te"n#" ah#tan, D#unduh tan''a$ = me# >1>, Tersed#a d#7! 000,0ord(ress,com

=, Nuru$ #tr#/ 7e*erat #$mu bedah /mater#a$ suture/ >1>
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