GAMBARAN KEJADIAN INFEKSI LUKA OPERASI (ILO) PASCA BEDAH ABDOMEN DI RSUD ABDUL WAHAB SJAHRANIE SAMARINDA
Abstract
Infeksi luka operasi (ILO) adalah infeksi pada bagian tubuh yang terpapar oleh ahli bedah saat prosedur invasive. ILO merupakan salah satu infeksi nosokomial yang paling umum dan paling dapat dicegah diantara infeksi nosokomial lainnya, namun kejadian infeksi luka operasi terutama pada bedah abdomen masih menunjukkan beban yang signifikan. Faktor resiko infeksi luka operasi meliputi usia tua, jenis luka operasi, penyakit penyerta seperti diabetes mellitus, pemberian antibiotik profilaksis yang tidak adekuat, status gizi pasien seperti obesitas dan malnutrisi serta durasi operasi yang panjang. Penelitian ini bertujuan untuk mengetahui gambaran kejadian infeksi luka operasi pasca bedah abdomen di RSUD Abdul Wahab Sjahranie Samarinda. Metode penelitian ini adalah penelitian deskriptif laboratorik. Data penelitian diambil dari swab luka operasi dan data rekam medik pada 40 pasien pasca bedah abdomen yang melakukan pergantian perban pertama kali serta memenuhi kriteria inklusi dan eksklusi. Hasil penelitian menunjukkan 30 orang (75%) pasien mendapatkan infeksi luka operasi. Mayoritas pasien terinfeksi berusia diatas 40 tahun, yaitu pada 15 pasien (37,5%). Sebagian besar pasien terinfeksi mendapatkan luka bersih terkontaminasi, yaitu 23 pasien (57,5%). Mayoritas pasien terinfeksi yaitu 27 pasien (67,5%) tidak memiliki penyakit penyerta. Bakteri gram positif, yaitu Staphylococcus epidermidis merupakan bakteri penginfeksi terbanyak yang teridentifikasi pada 10 orang (33,3%) pasien. Seluruh pasien terinfeksi, yaitu 30 pasien (75%) mendapatkan antibiotik profilaksis. Mayoritas pasien terinfeksi memiliki status gizi normal, yaitu 17 orang (42,5%), dan kejadian infeksi lebih banyak terjadi pada pasien dengan durasi <120 menit, yaitu 20 orang (50%) pasien.
Kata Kunci : Infeksi Luka Operasi, ILO, Bedah Abdomen, Faktor Resiko Infeksi Luka Operasi
Surgical site infection (SSI) is an infection at the part of the body that was exposed by a surgeon during an invasive procedure. SSI is one of the most common and most preventable nosocomial infection among other nosocomial infections, but the incidence of surgical site infections especially in abdominal surgery still shows a significant burden. Risk factors of surgical site infections include old age, type of surgical wound, comorbidities such as diabetes mellitus, inadequate prophylactic antibiotics, nutritional statuses such as obesity and malnutrition and long duration of surgery. This study aimed to explain an overview of the incidence of postoperative abdominal wound infection in Abdul Wahab Sjahranie General Hospital, Samarinda. This research method was a laboratory descriptive study. The research data was taken from surgical wound swabs and medical record data of 40 post-abdominal surgery patients who made the bandage changes for the first time and met the inclusion and exclusion criteria. The results showed 30 patients (75%) had surgical site infections. The highest percentage of infected patients aged over 40 years, i.e. in 15 people (37.5%). Most of the infected patients had clean contaminated wounds, i.e. in 23 patients (57.5%). The majority of infected patients did not have concomitant diseases, i.e. 27 people (67.5%). Gram-positive bacteria, specifically Staphylococcus epidermidis was the most infectious bacteria identified in 10 patients (33.3%). All infected patients, i.e. 30 patients (75%) received prophylactic antibiotics. The highest frequencies of infected patients had normal nutritional status, i.e.17 patients(42.5%), and the incidence of infection was more common in patients with duration <120 minutes, i.e. 20 patients (50%).
Keywords : Surgical Site Infection, SSI, Abdominal Surgery, Risk Factors
References
Agrawal, A. and Singh, R. P. (2014) ‘Surgical Site Infection in Abdominal Surgeries: a Clinical Study’, Journal of Evolution of Medical and Dental Sciences, 3(40), pp. 10188–10193. doi: 10.14260/jemds/2014/3324.
Al-Niaimi, A. N. et al. (2015) ‘Intensive postoperative glucose control reduces the surgical site infection rates in gynecologic oncology patients’, Gynecologic Oncology. Elsevier B.V., 136(1), pp. 71–76. doi: 10.1016/j.ygyno.2014.09.013.
Alkaaki, A. et al. (2019) ‘Surgical site infection following abdominal surgery: A prospective cohort study’, Canadian Journal of Surgery, 62(2), pp. 111–117. doi: 10.1503/cjs.004818.
Behnke, M. et al. (2013) ‘Nosokomiale Infektionen und Antibiotika-Anwendung: Zweite nationale Prävalenzstudie in Deutschland’, Deutsches Arzteblatt International, 110(38), pp. 627–633. doi: 10.3238/arztebl.2013.0627.
Beliman, G., & Dunn, D. (2015). Surgical Infection. Dalam: Brunicardi, C. (ed.). Schwartz's Principles Of Surgery. Edisi ke-10. McGraw Hill Education, New York, pp. 135-160
Blanchard, D. (2015) ‘Prophylactic antibiotics to prevent surgical site infection after breast cancer surgery’, Clinical Journal of Oncology Nursing, 19(5), pp. 629–630. doi: 10.1188/15.CJON.629-630.
CDC (2019) ‘Procedure-associated Module SSI Surgical’, Cdc, (January), pp. 20–31. doi: 10.1080/17436753.2016.1267942.
Chessa, D., Ganau, G. and Mazzarello, V. (2015) ‘An overview of staphylococcus epidermidis and staphylococcus aureus with a focus on developing countries’, Journal of Infection in Developing Countries, 9(6), pp. 547–550. doi: 10.3855/jidc.6923.
Cogen, A. L., Nizet, V. and Gallo, R. L. (2008) ‘FROM BENCH TO BEDSIDE Skin microbiota : a source of disease or defence ?’, British Journal of Dermatology, 158, pp. 442–455.
Collaborative, G. (2017) ‘Determining the worldwide epidemiology of surgical site infections after gastrointestinal resection surgery: Protocol for a multicentre, international, prospective cohort study (GlobalSurg 2)’, BMJ Open, 7(7), pp. 1–7. doi: 10.1136/bmjopen-2016-012150.
Dobner, J. and Kaser, S. (2018) ‘Body mass index and the risk of infection - from underweight to obesity’, Clinical Microbiology and Infection. Elsevier Ltd, 24(1), pp. 24–28. doi: 10.1016/j.cmi.2017.02.013.
Dokken, B. B. (2008) ‘The pathophysiology of cardiovascular disease and diabetes: Beyond blood pressure and lipids’, Diabetes Spectrum, 21(3), pp. 160–165. doi: 10.2337/diaspect.21.3.160.
Emil, A. et al. (2015) ‘Surgical site infections after abdominal surgery: Incidence and risk factors. A prospective cohort study’, Infectious Diseases, 47(11), pp. 761–767. doi: 10.3109/23744235.2015.1055587.
Faridah, I. N., Andayani, T. M. and Inayati, I. (2012) ‘Pengaruh Umur Dan Penyakit Penyerta Terhadap Resiko Infeksi Luka Operasi Pada Pasien Bedah Gastrointestinal’, Pharmaciana, 2(2). doi: 10.12928/pharmaciana.v2i2.668.
‘Global Guidelines for the Prevention of Surgical Site Infection’ (2016). Available at: http://www.who.int.
Haryanti, L. et al. (2016) ‘Prevalens dan Faktor Risiko Infeksi Luka Operasi Pascabedah’, Sari Pediatri, 15(4), p. 207. doi: 10.14238/sp15.4.2013.207-12.
Hu, T. et al. (2018) ‘Incidence and risk factors for incisional surgical site infection in patients with Crohn’s disease undergoing bowel resection’, Gastroenterology Report, 6(3), pp. 189–194. doi: 10.1093/gastro/goy007.
Janugade, H. B. et al. (2016) ‘Abdominal Surgical Site Infection Occurrence and Risk Factors in Krishna Institute of Medical’, 3(11), pp. 53–56. doi: 10.17354/ijss/2016/56.
Kallstrom, G. (2014) ‘Are quantitative bacterial wound cultures useful?’, Journal of Clinical Microbiology, 52(8), pp. 2753–2756. doi: 10.1128/JCM.00522-14.
Kiran, R. P. et al. (2015) ‘Combined preoperative mechanical bowel preparation with oral antibiotics significantly reduces surgical site infection, anastomotic leak, and ileus after colorectal surgery’, Annals of Surgery, 262(3), pp. 416–423. doi: 10.1097/SLA.0000000000001416.
Kumar, V., Abbas, A. K., & Aster, J. C. (2013).Robbins Basic Pathology.Edisi ke-9. Elsevier.Singapura.
Kunkemoeller, B. and Kyriakides, T. R. (2017) ‘Redox Signaling in Diabetic Wound Healing Regulates Extracellular Matrix Deposition’, Antioxidants and Redox Signaling, 27(12), pp. 823–838. doi: 10.1089/ars.2017.7263.
Kurnia, A., Tripriadi, E. S. and Andrini, F. (2013) ‘Gambaran Penderita Infeksi Luka Operasi pada Pasien Pasca Operasi Bersih ( Clean ) di RSUD Arifin Achmad Provinsi Riau’, Journal of Chemical Information and Modeling, 53(9), pp. 1689– 1699. doi: 10.1017/CBO9781107415324.004.
Liu, W. et al. (2014) ‘Third-generation cephalosporins as antibiotic prophylaxis in neurosurgery: What’s the evidence?’, Clinical Neurology and Neurosurgery. Elsevier B.V., 116, pp. 13–19. doi: 10.1016/j.clineuro.2013.10.015.
Montecino-rodriguez, E. et al. (2013) ‘Causes , consequences , and reversal of immune system aging Find the latest version : Review series Causes , consequences , and reversal of immune system aging’, The Journal of clinical investigation, 123(3), pp. 958–965. doi: 10.1172/JCI64096.958.
Negi, V. et al. (2015) ‘Bacteriological profile of surgical site infections and their antibiogram: A study from resource constrained rural setting of Uttarakhand state, India’, Journal of Clinical and Diagnostic Research, 9(10), pp. DC17-DC20. doi: 10.7860/JCDR/2015/15342.6698.
Otto, M. (2009). Staphylococcus epidermidis - the "accidental" pathogen. Nat Rev Microbiol , 7(8), pp. 555-567. https://doi.org//10.1038/nrmicro2182.
Roy, M.-C. (2014) ‘A Guide to Infection Control in the Hospital’, Infection control & urological care, 7(1), p. 16. Available at: www.isid.org.
Spagnolo, A. M. et al. (2013) ‘Operating theatre quality and prevention of surgical site infections’, Journal of Preventive Medicine and Hygiene, 54(3), pp. 131–137.
Steiner, H. L. and Strand, E. A. (2017) ‘Surgical-site infection in gynecologic surgery: pathophysiology and prevention’, American Journal of Obstetrics and Gynecology. Elsevier Inc., 217(2), pp. 121–128. doi: 10.1016/j.ajog.2017.02.014.
Thelwall, S. et al. (2015) ‘Impact of obesity on the risk of wound infection following surgery: Results from a nationwide prospective multicentre cohort study in England’, Clinical Microbiology and Infection. Elsevier Ltd, 21(11), p. 1008.e11008.e8. doi: 10.1016/j.cmi.2015.07.003.
Warganegara, E., Apriliana, E. and Ardiansyah, R. (2012) ‘Identifikasi Bakteri Penyebab Infeksi Luka Operasi ( ILO ) Nosokomial Pada Ruang Rawat Inap Bedah dan Kebidanan RSAM di Bandar Lampung’, Prosiding SNSMAIP III, (978-602-985591–3), pp. 344–348.
Winfield, R. D. et al. (2016) ‘Obesity and the risk for surgical site infection in abdominal surgery’, American Surgeon, 82(4), pp. 331–336.
Xia, J., Gao, J. and Tang, W. (2016) ‘Nosocomial infection and its molecular mechanisms of antibiotic resistance’, BioScience Trends, 10(1), pp. 14–21. doi: 10.5582/bst.2016.01020.
Ziebuhr, W. et al. (2006) ‘Nosocomial infections by Staphylococcus epidermidis: how a commensal bacterium turns into a pathogen’, International Journal of Antimicrobial Agents, 28(SUPPL. 1), pp. 14–20. doi: 10.1016/j.ijantimicag.2006.05.012
Copyright (c) 2020 Sepriani indriati Azis
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Proposed Policy for Journals That Offer Open Access
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).