Efek Oksigen Konsentrasi Tinggi Pascaoperasi Laparotomi pada Peritonitis terhadap Tingkat Infeksi Luka Operasi

Abstract

Metode sederhana untuk menambah tekanan oksigen secara adekuat pada perfusi jaringan yaitu dengan menambah konsentrasi oksigen yang diinspirasi pada penderita pascalaparotomi. Untuk melihat efektivitas oksigen konsentrasi tinggi tersebut dilakukan uji klinis di Rumah Sakit Dr. Hasan Sadikin Bandung. Dilakukan uji klinis secara random pada 102 penderita yang menjalani laparotomi karena peritonitis lokal atau difus serta membagi penderita dalam dua grup masing-masing 51 penderita untuk mendapatkan oksigen 30% dan 80% selama 2 jam pascaoperasi. Oksigen 30% didapat dari nasal kanul dengan oksigen 3 liter, sedangkan oksigen 80% diperoleh dari nonrebreathing mask dengan oksigen 10 liter. Penanganan anestesi dilakukan standar dan semua penderita mendapat antibiotik profilaksis. Dengan menggunakan protokol single blind, luka dievaluasi saat penderita pulang atau hari ke-7 jika masih dirawat dan 2 minggu pascaoperasi. Uji klinis dilakukan di subbagian Bedah Digestif RSHS selama periode Oktober 2009–Mei 2010. Dari 51 penderita yang diberi oksigen 80%, terdapat 2 (4%) penderita mengalami infeksi luka operasi dibandingkan dengan 9 dari 51 penderita (18%) yang diberi 30% oksigen. Durasi perawatan di rumah sakit sama pada kedua grup penderita. Simpulan, pemberian terapi oksigen konsentrasi tinggi pascaoperasi dapat menurunkan insidensi infeksi luka operasi. [MKB. 2012;44(3):165–9].

Kata kunci: Infeksi luka operasi, laparotomi, oksigen, peritonitis

Effect of Laparotomy Post-Operative High Concentration Oxygen in Peritonitis to Surgical Wound Infection Level

A simple method to improve oxygen pressure to tissue perfusion adequately is by increasing the concentration of inspired oxygen.We therefore tested the hypothesis that the supplemental administration of oxygen during the post-operative period decreases the incidence of wound infection.We randomly assigned 102 patients at Dr. Hasan Sadikin Hospital who underwent exploratory laparotomy due to local and diffuse peritonitis to receive 30 percent or 80 percent inspired oxygen for two hours post-operation. The 30% oxygen was obtained from the nasal canule and 3 litres of oxygen whereas 80% oxygen was obtained from non-rebreathing mask and 10 litres of oxygen. Using the single-blind protocol, wounds were evaluated before the patients were discharged or 7 days post-operative and then two weeks after surgery. The clinical trial was performed at Dr. Hasan Sadikin Hospital Bandung between October 2009–May 2010. From the 51 patients who received 80% oxygen, 2 (4%) had surgical-wound infections, whereas from the 51 patients given 30 percent oxygen, 9 (18%) had surgical-wound infections. The length of hospital stay for both groups were the same. In conclusion that post-operative administration of high concentration ofoxygen can reduce the incidence of surgical-wound infections. [MKB. 2012;44(3):165–9].

Key words: Laparotomy, oxygen, periotonitis, surgical wound infection


DOI: http://dx.doi.org/10.15395/mkb.v44n3.83