PERBANDINGAN KEJADIAN INFEKSI DAERAH OPERASI SUPERFISIAL ANTARA PENCUCIAN LUKA OPERASI DENGAN POVIDONE IODINE 10% DAN NaCl 0,9% PADA PASIEN LAPAROTOMI AKIBAT PERFORASI SALURAN CERNA
DOI:
https://doi.org/10.53625/jirk.v1i10.1731Keywords:
Infeksi Daerah Operasi, Pencucian Luka Operasi, Povidone Iodine, Laparotomi, Peritonitis, Perforasi Saluran CernaAbstract
Infeksi daerah operasi (IDO) merupakan salah satu komplikasi yang paling sering dan paling serius setelah pembedahan. Hal ini menyebabkan morbiditas dan mortalitas yang signifikan pada pasien dan menyebabkan bertambahnya lama perawatan dan biaya kesehatan. Pada luka kotor atau terinfeksi insidensi dari IDO mencapai 30-40%. Salah satu faktor yang berperan adakah tingginya kontaminasi dan jumlah bakteri pada luka insisi. Pencucian luka insisi adalah salah satu upaya dalam menurunkan IDO dengan menurunkan jumlah bakteri yang mengkontaminasi. Berbagai macam larutan yang digunakan unruk pencucian luka insisi, salah satunya adalah povidone iodine. Efektivitas dari pencucian luka dengan povidone iodine masih kontroversial.
Penelitian ini adalah penelitian double blinded randomized controlled study untuk membandingkan insidensi dari IDO superfisial pada pasien peritonitis akibat perforasi traktus gastrointestinal yang menjalani laparotomi kemudian dialokasikan untuk mendapatkan pencucian luka dengan povidone iodine atau pencucian luka dengan normal salin setelah penutupan fascia dan sebelum penutupan kulit. Pasien kemudian diikuti selama tiga puluh hari untuk dinilai adanya IDO. Luaran utama yang dinilai adalah terjadinya IDO. Insidensi IDO pada kedua kelompok kemudian dibandingkan.
Terdapat 83 orang pasien yang diikutsertakan pada penelitian ini dan kemudian dibagi menjadi dua kelompok, yaitu kelompok kontrol 40 orang yang menjalani pencucian luka dengan NaCl 0.9% steril dan 43 orang pada kelompok intervensi yang menjalani pencucian luka insisi dengan povidone iodine. Insidensi IDO adalah 6 pasien (13.95%) pada kelompok povidone iodine dan 13 orang (32.50%) pada kelompok NaCl 0,9%. Tes Chi square digunakan untk menganalisis insiden antar kedua grup. Didapatkan insidensi IDO secara signifikan lebih rendah pada kelompok povidone iodine dengan P< 0.044.
Pencucian luka insisi dengan povidone iodine bermanfaat dalam menurunkan insidensi IDO superfisial pada luka kotor (luka kelas IV).
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