Pengaruh Malnutrisi dan Faktor lainnya terhadap Kejadian Wound Dehiscence pada Pembedahan Abdominal Anak pada Periode Perioperratif
Sari
Latar belakang.Wound dehiscenceadalah salah satu komplikasi bedah abdominal yang jarang ditemui, namun
sering menyebabkan kematian, meningkatkan lama rawat, biaya, dan risiko infeksi berat dengan akibat kematian. Malnutrisi dianggap sebagai salah satu faktor yang berkontribusi terhadap kejadian dehiscencetersebut.
Tujuan.Menilai angka kejadiandehiscencebedah mayor pada anak yang berbeda status gizi, risiko relatif
serta faktor lain yang mempengaruhi risiko dehiscence.
Metode. Penelitian kohort prospektif pada 262 kasus bedah abdominal mayor pada anak. Pasien yang
memenuhi kriteria dibagi 2 kelompok yaitu menderita malnutrisi dan tidak. Tata laksana dilakukan sesuai
standar Bagian Bedah Anak RSAB Harapan Kita. Pengamatan dilakukan selama periode perioperatif sampai
pulang dari rumah sakit. Dihitung angka kejadian, risiko relatif, dan faktor atribusi dehiscence. Pengolahan
data dan analisis menggunakan SPSS versi 11.5 dan Open Epi
Hasil.Angka kejadian dehiscence2,7% (7/262), satu pasien gizi baik (0,8%), gizi kurang 2/7(1,7%), gizi
buruk 4/4(100%). Terjadi pada hari kelima pasca operasi (kisaran 3-7hari). Lama rawat 25 hari (14-73) vs
10 hari (1-10) tidak dehiscence. Meninggal dunia 1/7dehiscence. Risiko dehiscencemeningkat secara bermakna
pada gizi buruk vsgizi baik (RR136, IK95% 19,3-958,6, p=0,000). Hipoalbumin vsnormal (RR23,6,
IK95% 5,8-95,4, p=0,000). Anemia vsnormal (RR18,6, IK95% CI3.7-91.9, p=0,000). Sepsis vsnormal
(RR10,7, IK95% 2,5-45,5, p=0,000). Faktor atribusi dehiscence99,3% karena gizi buruk, hipoalbumin
96,6%, sepsis 90,7%, gizi kurang 59%.
Kesimpulan.Status gizi buruk, hipoalbumin, dan sepsis berperan hampir seratus persen terhadap kejadian
dehiscencepada anak. Saran, perlu dilakukan skoring risiko tinggi dehiscencepada anak yang akan menjalani
bedah mayor.
Kata Kunci
Teks Lengkap:
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DOI: http://dx.doi.org/10.14238/sp14.2.2012.110-6
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