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Analysis of Chest Tube Scars on the Use of Conventional versus Knotless Methods Claudia Loho; Mendy Hatibie; Adrian Tangkilisan; Wega Sukanto; Fredrik G. Langi
e-CliniC Vol. 10 No. 1 (2022): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v10i1.36927

Abstract

Abstract: Removal of chest tube is a one of the most distressing and frustrating experience for patients. Moreover, it has a tendency of scar formation. A relatively new method has been developed using a type of suture without knots (knotless). Assessment of scar is an objective and subjective method performed by using patient and observer scar assessment scale (POSAS). This study was aimed to assess the scars formed due to chest tube removal using conventional and knotless sutures. This was a controlled trial design. The Mann-Whitney test was used to compare the PSOAS scores of scars formed due to conventional and knotless sutures performed by patients and observers after three months, and obtained a p-value of less than 0.05. In conclusion, scar formation due to knotless suture is more acceptable for patients compared to conventional suture among chest tube removal wounds; therefore, the knotless suture can be a cosmetically alternative for wound closure management. Keywords: chest tube; scar tissue; knotless suture; conventional suture Abstrak: Pelepasan chest tube merupakan hal yang menyakitkan dan pengalaman yang membuat frustasi bagi pasien. Selain itu, tindakan ini berpeluang menyebabkan pembentukan jaringan parut. Telah dikembangkan metode baru dengan material jahitan baru yang tidak perlu disimpul. Penilaian jaringan parut dapat berupa penilaian obyektif dan subyektif dengan menggunakan Patient and Observer Scar Assessment Scale (POSAS). Penelitian ini bertujuan untuk menilai jaringan parut akibat pelepasan chest tube antara penjahitan metode konvensional dan knotless. Desain penelitian ialah controlled trial. Penilaian PSOAS baik dari pasien, observer, atau keduanya dilakukan tiga bulan kemudian terhadap jaringan parut yang terbentuk akibat penggunaan kedua metode. Perbandingan hasil skor PSOAS dianalisis dengan uji Mann-Whitney yang mendapatkan nilai p<0,05. Simpulan penelitian ini ialah pembentukan jaringan parut pada metode knotless lebih akseptabel bagi pasien dibandingkan metode konvensional. Hal ini dapat menjadi salah satu metode alternatif penutupan luka chest tube dengan hasil yang lebih dapat diterima.Kata kunci: chest tube; jaringan parut; metode knotless; metode konvensional
Perbaikan Klinis Sindroma Pasca Komosio dengan Terapi Oksigen Hiperbarik Mardoni Setiawan; Maxmillian Ch. Oley; Eko Prasetyo; Mendy Hatibie Oley
JBN (Jurnal Bedah Nasional) Vol 7 No 1 (2023): JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/JBN.2023.v07.i01.p02

Abstract

Tujuan: Tujuan penelitian ini untuk membuktikan bahwa terapi oksigen hiperbarik (TOHB) mempercepat proses penyembuhan kumpulan gejala pasien cedera kepala ringan (CKR). Metode: Penelitian ini didapatkan sebanyak 20 pasien CKR dan diikutsertakan dalam penelitian. Penelitian ini menggunakan rancangan controlled trial yang membandingkan kondisi outcome 2 kelompok perlakuan, yakni pasien CKR dengan TOHB vs. kontrol. Kelompok kontrol akan menerima terapi standar CKR menurut protokol Advanced Trauma Life Support (ATLS). Setelah penanganan sesuai protokol ATLS, kelompok TOHB akan mendapatkan juga sesi TOHB, yaitu oksigen bertekanan 2-3 atmosphere absolute (ATA) dengan 100% oksigen dalam ruang udara bertekanan tinggi, selama 60 menit. Hasil: Skor Rivermead Post-Concussion Symptoms Questionnaire (RPQ), baik ketiga item awal (RPQ-3) yang berhubungan dengan gejala awal cedera kepala maupun ketiga belas item berikutnya (RPQ-13) yang memuat gejala lanjut cedera kepala, tidak berbeda pada kedua kelompok penelitian sebelum pengobatan dilakukan. Namun diakhir minggu kelima pasca terapi pasien-pasien dengan TOHB memperlihatkan skor RPQ jauh lebih baik (rerata 3,1 vs. 6,5 pada RPQ-3, dan 14,2 vs. 29,6 pada RPQ-13. Hasil penelitian ini membuktikan bahwa TOHB terhadap pasien CKR terjadi penurunan skor RPQ, baik RPQ-3 dan RPQ-13 yang bermakna (p<0,001). Simpulan: Penelitian ini telah membuktikan pengaruh TOHB mempercepat proses penyembuhan kumpulan gejala pasien CKR (sindroma pasca komosio).
Burn Hypertrophic Scar Profile Based on POSAS Score at Prof. Dr. R. D. Kandou Hospital Manado Mendy Hatibie; Maximillian C. Oley; Eko S. Sinaga
e-CliniC Vol. 11 No. 2 (2023): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v11i2.46370

Abstract

Burn injury is skin damage due to extreme temperature resulting in hypertrophic scar if impaired of wound healing occurs that can impact on the quality of life. Evaluation of hypertrophic scar objectively and subjectively including scar quality and quality of life patient could performed with POSAS score. This study aimed to evaluate burn hypertrophic scar profile based on POSAS core at Prof. Dr. R. D. Kandou Hospital Manado. This was a retrospective study using medical records of burn patients from 2018 to 2020 at Prof. Dr. R. D. Kandou Hospital. The results obtained 64 samples. Most of the patients were male (75.0%). The most dominant age of patients was over the age of 21 years (79.7%). The most frequent cause of burns was exposure to hot water (71.9%) followed by fire (21.9%). The undergraduate education level was the most affected by burns (79.7%). The type of work most affected was the professional group (62.5%) followed by housewives (18.8%). Most of the wounds were superficial-middermal degree (71%) followed by superficial degree (15,6%) and deep dermal full thickness (12,5%). Assessment of hypertrophic scars using the POSAS score showed almost the same results between observers and patients. In conclusion, hypertrophic scar evaluation with POSAS score is very useful because it can evaluate the scar quality and the quality of life. POSAS score evaluation is depended on wound treatment, duration of wound healing, grading and wound burn area, and length of stay. Keywords: hypertrophic scar; POSAS score; quality of life
Efektivitas Terapi Oksigen Hiperbarik pada Nyeri Kronik Osteoartritis Lutut Benny G. Siahaan; Rangga Rawung; Mendy Hatibie
Medical Scope Journal Vol. 5 No. 2 (2023): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v5i2.46565

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Abstract: Osteoarthritis (OA) is a degenerative joint disease characterized by progressive cartilage degeneration, subchondral bone changes, osteophyte formation, sinovitis or arthritis. The aim of osteoarthritis management is to reduce pain, increase joint function, and decrease disability. Hyperbaric oxygen therapy (HBOT) can inhibit astrocyte activation and inflammatory factor production, and maintain transmission and intergration of sensoric information through dorsal neurons, therefore, resulting in pain reduction. This study aimed to evaluate the effectiveness of HBOT in chronic pain of knee osteoarthritis. This was a parallel, two-arm, placebo-controlled, randomized clinical trial in adults with knee osteoarthritis at two hospitals in Manado, namely Badan Layanan Umum Rumah Sakit Umum Pusat Prof. Dr. R. D. Kandou and Rumah Sakit Siloam. The results obtained 44 patients suffered from knee osteoarthritis grade 1 dan 2 associated with chronic pain as subjects, divided into two groups namely intervention with HBOT and control groups. Determination of normality of numeric variables was performed with Shapiro-Wilk test. The statistic test confirmed that the distribution of VAS scores was relatively not different between before and after HBOT, and the control group (p=0.421 and p=0.634). In conclusion, hyperbaric oxygen therapy can be used to reduce chronic pain in knee osteoarthritis. Keywords: knee osteoarthritis; hyperbaric oxygen therapy; chronic pain   Abstrak: Osteoartritis (OA) merupakan suatu penyakit sendi degeneratif yang dikarakteristikkan dengan degenerasi kartilago progresif, perubahan tulang subkondral, pembentukan osteofit, dan sinovitis atau inflamasi sendi. Tujuan penatalaksanaan OA ialah untuk meredakan nyeri, meningkatkan fungsi, dan membatasi disabilitas Terapi oksigen hiperbarik (TOHB) dapat menginhibisi aktivasi astrosit dan produksi faktor inflamatorik serta mempertahankan transmisi dan integrasi informasi sensori melalui neuron dorsal sehingga nyeri menurun. Penelitian ini bertujuan untuk menilai efektifitas TOHB dalam penatalaksanaan nyeri kronik pada OA lutut. Penelitian ini didesain sebagai suatu parallel, two-arm, placebo-controlled, randomized clinical trial pada dewasa dengan OA lutut di dua rumah sakit di Manado, Badan Layanan Umum Rumah Sakit Umum Pusat Prof. Dr. R. D. Kandou dan Rumah Sakit Siloam. Sebanyak 44 pasien OA lutut grade 1 dan 2 dengan nyeri kronik menjadi subjek penelitian, yang dibagi secara acak atas dua kelompok: intervensi TOHB dan kontrol. Penentuan normalitas variabel numerik dilakukan menggunakan uji Shapiro-Wilk. Hasil statistik mengonfirmasi distribusi penurunan skor VAS relatif tidak berbeda bermakna sebelum dan setelah TOHB dan kelompok kontrol (p=0,421 dan p=0,634). Simpulan penelitian ini terapi oksigen hiperbarik kemungkinan dapat menurunkan nyeri kronik pada penderita osteoartristis lutut. Kata kunci: osteoartritis lutut; terapi oksigen hiperbarik; nyeri kronik
Penilaian Parut Hipertrofi Luka Bakar Berdasarkan Patient and Observer Scar Assessment Scales (POSAS) Eko S. Sinaga; Mendy Hatibie; Maximillian C. Oley; Fredrik G. Langi
Medical Scope Journal Vol. 6 No. 1 (2024): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v6i1.46566

Abstract

Abstract: Hypertrophic scar of burn can occur due to the imbalances in the wound healing process that can affect the quality of life. Patient and Observer Scar assessment Scales (POSAS) is an assessment instrument both from the patient and the observer. This study aimed to assess hypertrophic scars with POSAS. This was an observational and analytical study with a cross sectional design. Samples were patient with burns admitted to Prof. Dr. R. D. Kandou Hospital, Manado, and its network hospitals. The assessment was carried out directly when the patients being admitted to the hospital. Each patient who met the requirements had demographic and clinical data taken. Subsequent assessments were carried out at one month and six months after the initial treatment procedure. The results obtained 30 patients with burn dominated by females (63%). The most common degree of burns was superficial-middermal (67%). The assessment of POSAS by doctors and patients tended to be the same and both decreased in the first month and the sixth month after initial treatment procedure with a mean value of the total pre- initial treatment procedure score of 51.3±12.1; 1st month 44.2±9.5; 6th month 30.3±5.9. In conclusion, the evaluation of burns that produce acceptable hypertrophic scars using the POSAS score shows similarities in the assessment of observers and patients. Moreover, precautions at the beginning of the observation will affect the POSAS score Keywords: burn; hypertrophic scar; Patient and Observer Scar Assessment Scales   Abstrak: Parut hipertrofi paska luka bakar dapat terjadi karena ketidakseimbangan pada proses penyembuhan luka yang dapat memengaruhi kualitas hidup. Patient and Observer Scar Assessment Scales (POSAS) merupakan instrumen penilaian parut baik dari pasien maupun observer. Penelitian ini bertujuan untuk menilai parut hipertrofi dengan menggunakan POSAS. Jenis penelitian ialah observasional analitik dengan desain potong lintang. Sampel penelitian ialah pasien dengan luka bakar yang dirawat di RSUP Prof. Dr. R. D. Kandou dan rumah sakit jejaring. Penilaian dilakukan langsung saat pasien masuk rumah sakit. Setiap pasien yang memenuhi persyaratan diambil data demografik dan kliniknya. Penilaian selanjutnya dilakukan pada satu bulan dan enam bulan paska tindakan perawatan awal. Hasil penelitian mendapatkan 30 pasien dengan luka bakar yang didominasi oleh pasien perempuan (63%). Derajat luka bakar terbanyak ialah superficial-middermal (67%). Penilaian POSAS oleh dokter dan pasien cenderung sama dan mengalami penurunan baik pada bulan pertama dan bulan keenam setelah tindakan dengan nilai mean skor total pra tindakan 51,3±12,1; bulan pertama 44,2±9,5; dan bulan keenam 30,3±5,9. Simpulan penelitian ini ialah evaluasi luka bakar yang menghasilkan jaringan parut akseptabel menggunakan skor POSAS menunjukkan kesamaan penilaian menurut observer dan pasien. Tindakan pencegahan pada awal pengamatan akan memengaruhi skor POSAS. Kata kunci: luka bakar; parut hipertrofi; Patient and Observer Scar Assessment Scales
Karakteristik Pasien Operasi Rekonstruksi Hipospadia yang Menjalani Terapi Oksigen Hiperbarik di RSUP Prof. Dr. R. D. Kandou dan RS Siloam Manado Irawan Sukarno; Ari Astram; Mendy J. Hatibie; Fredrik G. Langi
e-CliniC Vol. 12 No. 1 (2024): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v12i1.46457

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Abstract: Hypospadias is a congenital abnormality of urethral meatus in male. Hypospadias can be corrected by urethroplasty. Hyperbaric oxygen therapy (HBOT) can accelerate wound healing after surgery by increasing oxygenation, angiogenesis, and collagen synthesis. This study aimed to describe the characteristics of hypospadias reconstructive surgery patients who underwent hyperbaric oxygen therapy. This was a quantitative and descriptive study. Data were analyzed with SPSS ver 22.0. The results showed that from 20 patients who underwent reconstructive hypospadias surgery, 10 patients received HBOT as adjuvant therapy and 10 patients received conservative therapy post-surgery. The mean age of patients who underwent HBOT was 17.4±7.1 years old. The most frequent type of hypospadias found was subcoronal (35%), followed by the other types: glandular (20%), distal penile (10%), midshaft penile (10%), proximal penile (10%), penoscrotal (10%), and the least was scrotal (5%). All of the patients underwent urethroplasty with Sidik-Chaula and Manset Flap method. In conclusion, the mean age of patients who underwent HBOT was 17.4±7.1 years old, and the most frequent type of hypospadias found was subcoronal. Keywords: hypospadias; hyperbaric oxygen therapy; characteristics of hypospadias patients   Abstrak: Hipospadia merupakan kelainan kongenital meatus uretra pada laki-laki. Hipospadia dapat dikoreksi dengan uretroplasti. Terapi oksigen hiperbarik (TOHB) dapat mempercepat penyembuhan luka pascaoperasi melalui peningkatan oksigenasi, angiogenesis, dan sintesis kolagen. Penelitian ini bertujuan untuk mengetahui karakteristik pasien rekonstruksi hipospadia yang menjalani TOHB. Jenis penelitian ialah deskriptif kuantitatif dengan alat analisis SPSS ver. 22.0. Hasil penelitian mendapatkan 20 pasien yang dilakukan operasi rekonstruksi hipospadia; 10 pasien menjalani TOHB dan 10 pasien menjalani terapi konservatif pasca pembedahan. Rerata usia pasien yang menjalani TOHB yaitu 17,4±7,1 tahun. Tipe hipospadia yang paling sering ialah subcoronal (35%), diikuti tipe glandular (20%), dan sisanya ialah tipe distal penile (10%), midshaft penile (10%), proximal penile (10%), penoscrotal (10%), dan yang paling sedikit ialah tipe scrotal (5%). Semua pasien menjalani operasi dengan metode Sidik-Chaula dan Manset Flap. Simpulan penelitian ini ialah rerata usia pasien yang menjalani TOHB ialah 17,4±7,1 tahun dengan tipe hipospadia yang paling sering ialah subcoronal. Kata kunci: hipospadia; terapi oksigen hiperbarik; karakteristik pasien hipospadia
Giant Dermatofibrosarcoma Protuberans Of The Frontoparietal Area: A Case Report Adam Rizky; Hatibie Mendy; Yuansun Kosama; Tjandra Djony
Jurnal sosial dan sains Vol. 4 No. 8 (2024): Jurnal Sosial dan Sains
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/jurnalsosains.v4i8.1519

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Background: Dermatofibrosarcoma protuberans (DFSP) is a rare, slow-growing, low to intermediate-grade soft tissue sarcoma. It is commonly found on the trunk, representing approximately 1-2% of all soft tissue sarcomas. Still, it may also manifest in the extremities or the head and neck, typically in adult patients. It is a locally aggressive neoplasm that tends to infiltrate adjacent structures but with a low potential for metastatic potential. It often presents complex clinical problems due to its high rates of recurrence. Purpose: The study aims to analyze the clinical and histopathological characteristics of DFSP through case reports, as well as provide guidance for effective treatment strategies. Method: We report a case of a 40-year-old male with a complaint of a recurring giant mass of the frontal area. Before the current complaint, the patient had undergone three separate surgeries for a mass growing in the exact location. The pathologic diagnosis was dermatofibrosarcoma protuberans. Result: The patient had undergone three previous surgeries for the same mass, with a histopathological diagnosis of DFSP. After a complete surgical excision with a wider margin, the patient showed no signs of recurrence four months after surgery. Conclusion: Considering the extent of the current mass, excision was chosen as the primary treatment, with wider surgical margins due to the infiltrative growth nature of the neoplasm. The patient was then followed up four months post-operation, showing no signs of recidivism.
Management of Crush Injury’s Complications Using Hyperbaric Oxygen Therapy: Case Series Arikalang, Patrick S.; Hatibie, Mendy J.; Oley, Maximillian C.; Noersasongko, Albertus D.; Suharso, Tommy
e-CliniC Vol. 12 No. 2 (2024): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v12i2.46847

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Abstract: Crush injury occurs due to an external trauma mechanism that directly affects the skin, muscle, and bone tissue. Crush injuries can involve several parts of the body at the same time. When accompanied by handling, wound healing in crush injury can be long-term, so that it can affect the function of the patient. Various complications that can occur ranging from secondary infection, necrosis, recurrent bleeding, to compartment syndrome. We reported serial cases of crush injury with various clinical presentations and complications, varying in the age range of 16-65 years. All four patients were given multiple managements, such as open reduction external fixation and extensive debridement. There were complications such as secondary infection and delay in the wound healing process in patients who did not on time for follow-up. The four patients received additional treatment in the form of wound dressings hyperbaric oxygen therapy (HBOT) with 5-10 90-minute sessions under 2.4 ATA pressure for 10 consecutive days. Follow-up was carried out again within a period of one month to compare the wound condition before and after HBOT. The clinical condition was getting better, marked by the formation of granulation tissue. The state of hyperoxia in HBOT accelerated the inflammatory process and angiogenesis during the wound healing process characterized by the eradication of bacteria in the wound tissue and accelerated neovascularization formation. In conclusion, adequate therapy, wound dressing, and patient compliance affect patient outcome. Moreover, the addition of hyperbaric oxygen therapy has shown to accelerate the wound healing process and restore the patient's limb function. Keywords: crush injury; hyperbaric oxygen therapy; oxygen; wound healing
Reconstruction of Lower Eyelid in Basal Cell Carcinoma Case with Adjunctive Hyperbaric Oxygen Therapy: A Case Report Chietra, Yulius A. M.; Hatibie, Mendy J.; Dali, Ramli
Medical Scope Journal Vol. 7 No. 1 (2025): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v7i1.54895

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Abstract: Basal cell carcinomas (BCCs) are the most common cancers in humans, caused by exposure to ultraviolet light and are associated with PTCH1 gene mutation. Its incidence rate significantly increases per year especially in elderly people. Several modalities are available for BCC treatment but surgery is still considered as the gold standard. Oxygen is mandatory for almost all wound healing processes, and oxygen substitution can be delivered in the form of hyperbaric oxygen (HBO) therapy. We presented a 70 years old woman with a major complaint of a tumor located in the left infrapalpebral region, below the left lower lash line with 5 years of evolution. Patient had clinical presentation of solid nodular basal cell carcinoma which was the most common clinical subtype. Patient was diagnosed as having BCC based on history taking, clinical findings, and histopathological examination. Surgical wide excision, skin flap, and HBO as the adjunctive therapy were performed on this patient. With these techniques, healing time was reduced, complications rates were low, and cosmetic outcome was much better. In conclusion, closing defects of BCC case with surgical wide excision and flap yields a remarkable outcome and an adjunctive HBO therapy after surgery optimizes the oxygenation, thus, the healing potential of tissue prior to surgery, and accelerates wound healing post operatively. A good result with short healing duration was observed. Keywords: basal cell carcinoma; hyperbaric oxygen therapy; flap; wound healing
Managing Neglected Burn Wound with Exposed Upper Tibia Using Multiple Modalities Kalangi, Cherry G; Hariyanto, Agus; Oley, Mendy Hatibie
Jurnal Plastik Rekonstruksi Vol. 2 No. 3 (2013): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2000.669 KB) | DOI: 10.14228/jpr.v2i3.244

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Background: Deep burn wound with exposed underlying structures such as muscle or moreover in this case, bone, may increase morbidity in the terms of infection. Therefore careful planning of reconstruction is needed. Patient and Method: We report one case of neglected burn wound with exposed tibia and muscle contracture on bilateral knee joint that was reconstructed in our Plastic Surgery Division of Prof RD Kandou Hospital. Data was taken from medical and surgery record. Result: We managed the muscle contracture of the left knee joint by sedated gradual stretching and splinting. We also utilized hyperbaric treatment in order to maximize granulation process. A medial gastrocnemius muscle flap followed by split thickness skin graft is used to reconstruct the missing tissue at upper tibia, and another split thickness skin graft to cover another wound at opposite upper leg. The result was satisfying without any complication. Conclusion: In managing a neglected burn wound with bone exposed and muscle contracture, it is compulsory to have a careful reconstruction planning. Our objectives are to release the muscle contracture and to provide an adequate coverage to the bone-exposed wound by using many modalities we have.