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All Journal Medula JURNAL PENELITIAN PERAWAT PROFESIONAL JK Unila (Jurnal Kedokteran Universitas Lampung) Jurnal Ilmiah STIKES Yarsi Mataram JPM (Jurnal Pengabdian Masyarakat) Ruwa Jurai
Risal Wintoko
Dosen Fakultas Kedokteran Universitas Lampung
Agriculture, Biological Sciences & Forestry Dentistry Education Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary

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Manajemen Terkini Perawatan Luka Wintoko, Risal; Yadika, Adilla Dwi Nur
Jurnal Kedokteran Universitas Lampung Vol 4, No 2 (2020): JK UNILA
Publisher : Fakultas Kedokteran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23960/jk unila.v4i2.2893

Abstract

Luka adalah terputusnya kontinuitas jaringan akibat substansi jaringan yang rusak atau hilang sehingga dapat menyebabkan kerusakan fungsi perlindungan kulit dan dapat disertai dengan kerusakan jaringan lain. Luka dapat terjadi akibat terjatuh, kecelakaan kendaraan bermotor, trauma tajam atau tumpul, maupun proses pembedahan. Jenis luka yang terjadi dapat berupa luka lecet (70,9%), luka robek (23,2%), luka memar, luka sayat, luka tusuk, maupun luka tembak. Prevalensi luka di Indonesia menurut Departemen Kesehatan Republik Indonesia tahun 2013 mencapai 8,2%. Perawatan luka umumnya masih menggunakan suatu metode untuk berbagai kondisi luka. Perawatan luka harus menyesuaikan kondisi dan problem luka yang terjadi sehingga proses penyembuhan luka dapat berlangsung dengan baik dalam waktu yang singkat tanpa adanya gangguan akibat luka yang akan berdampak pada produktivitas kerja dan biaya yang dikeluarkan dalam perawatan luka.Kata kunci: Luka, perawatan luka, kondisi luka, problem luka
Surgical Site Infection Lubis, Aisyah; Wintoko, Risal; Ismunandar, Helmi; Windarti, Indri
Medula Vol 14 No 2 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i2.956

Abstract

Surgical site infection (SSI) is a fairly common complication that can arise after surgery, both minor surgical procedures and more complex surgical procedures. This infection can occur due to the entry of pathogenic microorganisms into the surgical wound, causing an inflammatory reaction. This infection can prolong recovery time, increase mortality, require additional medical intervention, and affect the patient's quality of life. This impacts patient clinical outcomes as well as additional care costs. Factors such as surgical technique, cleanliness of the operating environment, use of implants, and the patient's health condition can influence and also contribute to increasing the risk of infection. Symptoms of surgical site infection include pain, swelling, redness, or the presence of pus in the surgical wound. When this infection occurs, immediate medical action is needed to prevent the spread of infection which can cause advanced conditions such as sepsis. Prevention of surgical site infections involves sterile measures before and during surgical procedures, the use of prophylactic antibiotics, and thorough post-operative monitoring. These efforts aim to reduce the risk of surgical site infections, ensure optimal recovery, and improve the overall results of the surgical procedure. An in-depth understanding of the risk factors and prevention of surgical site infections can help medical personnel provide quality care and ensure the success of the operation. There is also the importance of early detection and treatment of infections in patients undergoing surgery.
Uji Efektivitas Dekontaminasi Masker Bedah Menggunakan Rice Cooker Pada Masker yang Digunakan Mahasiswa Fakultas Kedokteran Universitas Lampung Tahun 2018 Gliselda, Vika Kyneissia; Soleha, Tri Umiana; Wintoko, Risal; Sidharti, Liana
Medula Vol 14 No 2 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i2.962

Abstract

Since the pandemic, there has been an increase in demand for surgical masks. This causes an increase in waste that is difficult to decompose and requires solutions such as decontamination so that it can be reused. Mask decontamination is currently still being carried out on a large scale and has been standardized. This is a drawback because it is difficult for the community to do. In Taiwan, there is one method of mask decontamination using a rice cooker which is widely available, but there are still many limitations in this research. The aim of this research is to determine the effectiveness of using a rice cooker as a decontamination tool against bacteria on surgical masks. This research was carried out on 20 samples of surgical masks used by students, consisting of calculating the number of colonies that grew before and after decontamination on Brain Heart Infusion Agar (BHI) media, gram staining, culture on blood agar plate media, catalase test and culture on mannitol media. salt agar. The type of bacteria on the surgical mask used is Bacillus sp. (85%) and Staphylococcus epidermidis (15%). The Wilcoxon statistical test regarding the effectiveness of surgical masks before and after showed a p value <0.05. The use of a rice cooker is effective as a tool for decontaminating surgical masks that have been used by students.
Hubungan Usia, Jenis Kelamin, dan Jarak Jahitan Luka dengan Kejadian Infeksi Luka Operasi pada Pasien Apendisitis Perforasi di RSUD Dr. H. Abdul Moeloek Provinsi Lampung Tahun 2020-2021 Caesarridha, Dhaifany Karissa; Wintoko, Risal; Mustofa, Syazili; Soleha, Tri Umiana
Medula Vol 14 No 5 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i5.1094

Abstract

Surgical site infection is a type of nosocomial infection with the most common occurrence, which is 38% of all cases of nosocomial infection. The distance of sutures affects the local hemodynamics around the surgical wound and can cause the inhibition of thrombus formation which plays a role in the wound healing process so that it will inhibit wound healing which will lead to increase of bacterial growth and cause infection and tissue damage. This study is an unpaired comparative analytic method with a cross-sectional research design. The sampling technique is total sampling. The research subjects were patients with perforated appendicitis at RSUD Dr. H. Abdul Moeloek, Lampung in 2020-2021, totaling 37 people. The independent variable in this study were age, gender, and the distance between the sutures, while the dependent variable was the incidence of surgical site infection. The study showed that the distance of sutures had a correlation with the incidence of surgical site infection with a p value of 0.00 (<0.05), where the distance of sutures that <2 cm has a higher frequency of surgical site infections than the distance of sutures that ≥2 cm. Age also has a correlation with the incidence of surgical site infection with a p value of 0.041 (<0.05). Meanwhile, gender did not have a correlation with the incidence of surgical site infection with a p value of 0.728 (> 0.05). We can conclude that the distance of sutures and age have a correlation with the incidence of surgical site infection. Otherwise, gender is not associated with the incidence of surgical site infection.
Health Belief Model Application Related to Safe Work Behavior Against Poisoning Prevention in Farmers Using Pesticides suharmanto, suharmanto; Hadibrata, Exsa; Wintoko, Risal
Jurnal Ilmiah STIKES Yarsi Mataram Vol. 15 No. 1 (2025): Jurnal Ilmiah STIKES Yarsi Mataram
Publisher : Sekolah Tinggi Ilmu Kesehatan YARSI Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57267/jisym.v15i1.432

Abstract

The World Health Organization estimates that pesticide poisoning occurs yearly in the world and Indonesia. This study aimed to analyze the influence of the Health Belief Model related to safe work behavior on the prevention of poisoning in farmers who use pesticides. This type of research is observational analytic, with a sample of 400 people. The data collection tool used a questionnaire. Data processing includes coding, tabulating, and cleaning. Data analysis used univariate (percentage) and bivariate using the Chi-Square test. The study found a relationship between the dimensions of the Health Belief Model related to safe work behavior on preventing poisoning in farmers who use pesticides. The conclusion of this study is that there is a relationship between the dimensions of the Health Belief Model and the prevention of poisoning in farmers who use pesticides, so it is hoped that the community can increase their knowledge by reading books, attending seminars, counseling and training related to the prevention of poisoning due to the use of pesticides. ABSTRAK World Health Organization memperkirakan setiap tahun terjadi keracunan pestisida di dunia dan Indonesia. Tujuan penelitian ini adalah menganalisis pengaruh Health Belief Model terkait perilaku kerja aman terhadap pencegahan keracunan pada petani pengguna pestisida. Jenis penelitian ini observasional analitik, dengan sampel 400 orang. Alat pengumpul data menggunakan kuesioner. Pengolahan data meliputi coding, tabulating dan cleaning. Analisis data menggunakan univariat (persentase) dan bivariat menggunakan uji Chi-Square. Penelitian mendapatkan adanya hubungan dimensi Health Belief Model terkait perilaku kerja aman terhadap pencegahan keracunan pada petani pengguna pestisida. Simpulan penelitian ini adalah ada hubungan antara dimensi Health Belief Model dengan pencegahan keracunan pada petani pengguna pestisida, sehingga diharapkan kepada masyarakat agar dapat meningkatkan pengetahuannya dengan cara membaca buku, mengikuti seminar, penyuluhan dan pelatihan terkait pencegahan keracunan akibat penggunaan pestisida.
Laporan Kasus : Multipel Kolelitiasis dan Kolesistitis Akut Moderat pada Laki-Laki 68 Tahun dengan Hipertensi Kronis Aswan, Naufal Rasyid; Wintoko, Risal
Medula Vol 15 No 1 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i1.1589

Abstract

Kolelitiasis (gallstones) is the deposition of crystals in the pacifier sac or in the pacifier duct, consisting of cholesterol, bilirubin, and pacifier. Although often asymptomatic and found incidentally, gallstones can cause right upper abdominal pain, nausea, vomiting, obstruction, cholangitis, and pancreatitis, especially after consuming oily or spicy foods. Obstruction of the cystic duct, either by stones or functional problems, can cause acute inflammation of the gallbladder (cholecystitis). Typical symptoms are usually biliary colic, including post-meal cramping pain in the right upper quadrant or epigastric pain radiating to the back or scapula, especially seen after eating high spicy foods, often accompanied by nausea and vomiting, while typical symptoms of cholecystitis are pain that does not go away, and a palpable mass in the right upper quadrant, causing congestion that is edematous and thickened. This disease occurs due to an imbalance involving lipids and bile salts in the bile stored in the gallbladder. Patient Mr. I, aged 68 years old have several risk factors and comorbid associated with Kolelitiasis and cholecystitis and the following case report presents a discussion of the patient's clinical features and laboratory test results related to the onset of this disease. The management given to this patient is operative management (Laparoscopic Cholecystectomy), drug management (analgesics), and non-drug management (education on lifestyle changes).
Laporan Kasus : Laki-laki 64 tahun dengan Kolangitis Akut disebabkan Koledokolithiasis dan Kelainan Anatomi Duktus Sistikus yang Bermuara pada Ductus Hepatikus Kiri serta Stenosis di Distal Duktus Koledokus: Risal wintoko, Adeodatus Yuda Handaya Wintoko, Risal
Jurnal Kedokteran Universitas Lampung Vol. 9 No. 1 (2025): JK UNILA
Publisher : Fakultas Kedokteran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23960/jkunila.v9i1.pp23-27

Abstract

ABSTRAK Pendahuluan : Kelainan struktur anatomi di mana ductus cysticus (saluran kandung empedu) langsung bermuara ke ductus hepaticus kiri merupakan variasi yang sangat jarang terjadi. Persentase kejadian variasi ini diperkirakan kurang dari 1% dari populasi. Hal ini termasuk dalam variasi anatomi duktus biliaris yang tidak biasa dan penting untuk dikenali, terutama saat melakukan prosedur bedah seperti laparoskopik kolesistektomi maupun explorasi ductus billiaris, guna menghindari cedera pada saluran empedu. Kasus : Seorang laki-laki usia 64 tahun datang dengan keluhan nyeri perut kanan atas, demam, mual-mual, mata tampak kuning dan badan terasa gatal. Pemeriksaan fisik di dapatkan murphy sign, sclera ikterik dan badan kuning, dari pemeriksaan USG abdomen didapatkan batu multiple di kantong empedu dengan ukuran diameter terbesar 0,8 cm dan batu multiple kecil-kecil di Common bile duct (CBD) yang menyebabkan diltasi Common bile duct sampai Intra hepatic bile duct (IHBD). Di lakukan laparoskopi explorasi CBD saat operasi ditemukan perlengketan gallbladder dengan omentum dan struktur billier sulit diidentifikasi, kemudian diputuskan di lakukan konversi laparotomi. Dilakukan adhesiolisis dan intra operatif cholangiografi di dapatkan ductus sistikus yang bermuara pada ductus hepatikus kiri dan stenosis di distal CBD. Kemudian di putuskan dilakukan kolesistektomi, extraksi batu di CBD serta bypass koledokoduodenostomi. Diskusi : Evaluasi radiologi dengan USG abdomen, CT scan abdomen, MRI abdomen sangat di butuhkan untuk memastikan anatomi struktur billier sebelum tindakan pembedahan di lakukan untuk menghindari komplikasi. Pemeriksaan pencitraan intraoperative seperti IOC, koledokoskopi ataupun USG intraoperatif sangat di butuhkan untuk memastikan struktur anatomis dan kelainan lain yang di dapat. Kesimpulan : Kolangitis akut pada pasien ini disebabkan oleh koledokolithiasis yang diperberat dengan kelainan anatomi dan stenosis distal. Pengenalan dini terhadap kelainan anatomi biliaris sangat penting dalam merencanakan intervensi terapeutik yang tepat. Kata kunci: Kolangitis akut, Koledokolithiasis, Kelainan anatomi bilier, Duktus sistikus, Stenosis duktus koledokus
PSEUDOANEURISMA ARTERI ILEOKOLIKA SEBAGAI KOMPLIKASI TRAUMA ABDOMEN TUMPUL: LAPORAN KASUS LANGKA Bastha, Sultan Mahathir; Wintoko, Risal
Medula Vol 15 No 3 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i3.1681

Abstract

Mesenteric artery pseudoaneurysm is a rare condition that can occur due to blunt abdominal trauma or postoperative complications. This lesion is often difficult to recognize early due to nonspecific symptoms, leading to diagnosis typically being made through imaging or intraoperative findings. Delayed management can result in serious complications, including bleeding and bowel necrosis. A 59-year-old female patient was reported to have arrived at the Emergency Department of Abdul Moeloeki Hospital with complaints of central abdominal pain for the past week, accompanied by nausea and vomiting. History of abdominal trauma was obtained from a fall in the bathroom one week prior, as well as a traffic accident one year ago. Physical examination revealed abdominal tenderness with muscle rigidity, decreased bowel sounds, and vital signs indicating tachycardia. Laboratory tests were within normal limits. Abdominal ultrasound showed a paraaortic cystic lesion. The patient then underwent exploratory laparotomy, where a pseudoaneurysm of the ileocolic artery was found along with necrosis of the ileum and cecum. A right hemicolectomy was performed. Histopathological examination of the tissue supported the diagnosis of pseudoaneurysm with necrosis. The patient successfully underwent the right hemicolectomy procedure without major postoperative complications. The clinical condition of the patient improved with stable postoperative recovery. Pseudoaneurysm of the ileocolic artery is a rare complication of blunt abdominal trauma that can lead to intestinal necrosis. Early diagnosis requires a high clinical suspicion and confirmation through imaging. Exploratory laparotomy with right hemicolectomy is the definitive therapy for cases with intestinal necrosis.
Peritonitis Tuberkulosis Wintoko, Risal; Tantona, Muhamad Dwiky; Perbasya, Sofia Tyasni Darma
Jurnal Penelitian Perawat Profesional Vol 6 No 6 (2024): Desember 2024, Jurnal Penelitian Perawat Profesional
Publisher : Global Health Science Group

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/jppp.v6i6.3611

Abstract

Peritonitis Tuberkulosis (PTB) merupakan inflamasi dari peritoneum parietal atau peritoneum viseral yang disebabkan oleh bakteri Mycobacterium tuberculosis dan sering mengenai seluruh peritoneum, organ-organ pada sistem gastrointestinal, mesenterium, atau organ genitalia interna. PTB merupakan kondisi klinis yang jarang terjadi dan sering terjadi kesalahan dalam diagnosis. Hal ini perlu digarisbawahi bahwa perlunya peningkatan kewaspadaan dalam mengetahui klinis dan diagnosis PTB. PTB didahului oleh infeksi Mycobacterium tuberculosis yang menyebar secara hematogen ke organ-organ di luar paru termasuk peritoneum yang diiringi dengan menurunnya daya tahan tubuh. Sementara, penjalaran langsung dapat terjadi dari kelenjar mesenterika atau dari tuberkulosis usus. Penelitian ini menggunakan metode literature review yang didapatkan dari beberapa sumber kepustakaan, antara lain dari Elsevier, PubMed, dan BMJ dengan kata kunci peritoneal, tuberculosis, dan abdominal tuberculosis yang diterbitkan dari tahun 2018 hingga tahun 2023. Metode analisis yang digunakan adalah systematic literature review yang mengidentifikasi, mengevaluasi, mengkaji serta mengembangkan secara sistematis penelitian yang ada dengan fokus topik yang sesuai dan relevan. Tujuan penelitian ini untuk mengetahui karakteristik PTB sehingga pasien dengan klinis PTB dapat didiagnosis dan ditatalaksana dengan baik. Diagnosis PTB dapat ditegakkan melalui anamnesis, pemeriksaan fisik, serta penunjang. Pasien dengan PTB mendapatkan terapi OAT seperti pada TB paru sementara intervensi bedah apabila ada obstruksi usus, perforasi usus, fistula, abses, dan perdarahan. Diagnosis yang segera dan pengobatan yang adekuat memberikan prognosis yang cukup baik.
Khitan dan Pengobatan Massal di Masa Pandemi Virus Corona 2019 dengan Penerapan Protokol Kesehatan Adaptasi Kebiasaan Baru di Desa Rejosari Natar Lampung Selatan Tahun 2020 Wintoko, Risal; Fauzi, Ahmad; Hadibrata, Exsa; Siregar, Bintang Abdi; Yusmaidi, Yusmaidi
JPM (Jurnal Pengabdian Masyarakat) Ruwa Jurai Vol. 5 No. 1 (2020): JURNAL PENGABDIAN MASYARAKAT RUWA JURAI
Publisher : FK Unila

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23960/jpmrj.v5i1.2810

Abstract

Khitan merupakan tindakan memotong atau menghilangkan sebagian atau seluruh kulit penutup depan dari penis. Khitan sangat bermanfaat untuk kesehatan yaitu mengurangi resiko infeksi saluran kencing, mengatasi fimosis, parafimosis, balaniditis dan dapat mengurangi resiko keganasan penis serta penyebaran penyakit menular seksual. Dalam masa pandemi virus corona banyak orang yang takut melaksanakan khitan dan pengobatan, oleh sebab itu dilaksanakan khitan dan pengobatan massal dengan penerapan protokol kesehatan. Metode pengabdian ini di laksanakan dengan promosi kegiatan pengabdian kepada masyarakat Rejosari, kemudian bagi yang berminat mendaftar ke panitia. Panitia akan melakukan screening untuk peserta khitan massal yang sesuai indikasi. Pelaksanaan kegiatan akan di laksanakan sesuai jadwal yang di tentukan dengan mengikuti protokol kesehatan. Hasil pengabdian masyarakat ini berupa telah di laksanakan pengobatan dan khitan massal di Sekolah Dasar Negeri 3 Rejosari, kecamatan Natar Lampung selatan tanggal 27 Agustus 2020 pada pukul 08.00-12.00 WIB yang di ikuti oleh peserta pengobatan gratis sebanyak 98 pasien dan yang menjalani khitan sebanyak 52 pasien. Petugas kesehatan sebanyak 5 dokter spesialis, 4 dokter umum, 6 perawat dan 27 mahasiswa Fakultas Kedokteran Universitas Lampung. Kesimpulan pengabdian masyarakat ini telah di lakukan khitan dan pengobatan massal terhadap pasien tidak mampu secara ekonomi.Kata kunci: Khitan, Pandemi, Pengobatan
Co-Authors Ade Yonata, Ade Aisyah Lubis, Aisyah Aswan, Naufal Rasyid Bastha, Sultan Mahathir Bayu Anggileo Pramesona Betta Kurniawan, Betta Caesarridha, Dhaifany Karissa Dewi Nur Fiana Dwita Oktaria Fauzi Ahmad Muda Gliselda, Vika Kyneissia Hadibrata, Exsa Hdibrata, Exsa Helmi Ismunandar Indri Windarti Iswandi Darwis Liana Sidharti, Liana Mayasari, Diana Oktadoni Saputra, Oktadoni Perbasya, Sofia Tyasni Darma Rahmayani, Fidha Risti Graharti Rizki Hanriko Rudiyanto, Waluyo Siregar, Bintang Abdi Suharmanto Susianti Sutyarso Syazili Mustofa Tantona, Muhamad Dwiky Tjahjo, Mars Dwi Tri Umiana Soleha Widia, Chyci Yadika, Adilla Dwi Nur Yusmaidi, Yusmaidi