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Journal : Medula

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.
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).
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.