karya tulis ilmiah pengaruh gel ekstrak daun...

i

KARYA TULIS ILMIAH

PENGARUH GEL EKSTRAK DAUN KENIKIR (COSMOS CAUDATUS

H.B.K) TERHADAP PENYEMBUHAN LUKA EKSISI TIKUS PUTIH

JANTAN (RATTUS NOVERGICUS STRAIN WISTAR)

Oleh:

MONICA ROSELLINI

201310330311162

UNIVERSITAS MUHAMMADIYAH MALANG

FAKULTAS KEDOKTERAN

2017

ii

PENGARUH GEL EKSTRAK DAUN KENIKIR (COSMOS CAUDATUS

H.B.K) TERHADAP PENYEMBUHAN LUKA EKSISI TIKUS PUTIH

JANTAN (RATTUS NOVERGICUS STRAIN WISTAR)

KARYA TULIS AKHIR

Diajukan kepada

Universitas Muhammadiyah Malang

untuk Memenuhi Salah Satu Persyaratan

dalam Menyelesaikan Program Sarjana

Fakultas Kedokteran

Oleh:

Monica Rosellini

201310330311162

UNIVERSITAS MUHAMMADIYAH MALANG

FAKULTAS KEDOKTERAN

2017

iv

PERNYATAAN ORISINALITAS

Karya tulis akhir ini adalah karya saya sendiri, dan semua sumber baik yang

dikutip maupun dirujuk telah saya nyatakan dengan benar.

Nama : Monica Rosellini

NIM : 201310330311162

Malang, 27 Juli 2017

Penulis

vi

KATA PENGANTAR

Assalamu’alaikum Warahmatullah Wabarakatuh

Puji syukur kehadirat Allah SWT Yang Maha Pengasih lagi Maha

Penyayang dan atas karunia-Nya, penulisan tugas akhir ini dapat selesai dengan

baik. Shalawat serta salam selalu tercurahkan kepada Rasulullah Muhammad

shalallahu alaihi wasallam, keluarganya dan para sahabatnya yang telah berjasa

membawa syiar dakwah Islam ke seluruh dunia.

Penelitian tugas akhir ini berjudul “PENGARUH GEL EKSTRAK DAUN

KENIKIR (COSMOS CAUDATUS H.B.K) TERHADAP PENYEMBUHAN

LUKA EKSISI TIKUS PUTIH JANTAN (RATTUS NOVERGICUS STRAIN

WISTAR)”. Tugas akhir ini diajukan untuk memenuhi persyaratan Pendidikan

Sarjana Fakultas Kedokteran Universitas Muhammadiyah Malang.

Penulis menyadari tugas akhir ini masih jauh dari kata sempurna, oleh

karena itu, penulis sangat mengharapkan saran dan masukan yang membangun.

Semoga karya tulis ini dapat menambah wawasan keilmuan dan bermanfaat bagi

semua pihak.

Wassalamu’alaikum Warahmatullah Wabarakatuh

Malang, 22 Mei 2017

Penulis

vii

UCAPAN TERIMA KASIH

Allah SWT yang telah memberikan rahmat, karunia, kesehatan, dan

lindungan sehingga penulis dapat menyelesaikan tugas akhir ini.

dr. Irma Suswati, M.Kes, selaku Dekan Fakultas Kedokteran

Universitas Muhammadiyah Malang atas ilmu dan bimbingannya selama di

Fakultas Kedokteran UMM.

dr. Moch. Ma’roef, Sp.OG, selaku Pembantu Dekan I Fakultas

Kedokteran UMM atas kesediaan waktu, kesabaran dalam membimbing,

dan penyampaian ilmu yang sangat bermanfaat bagi masa depan para

mahasiswa FK UMM.

dr. Rahayu, Sp.S, selaku Pembantu dekan II Fakultas Kedokteran

UMM yang senantiasa bersabar dalam membimbing dan mengajarkan

ilmunya kepada kami.

dr. Iwan Sys Indrawanto, Sp.KJ, selaku Pembantu Dekan III, yang

penuh semangat dalam menyampaikan ilmu dan motivasi yang membangun

semangat kami selama menjalani pendidikan di Fakultas Kedokteran.

dr. Moch. Aleq Sander, M.Kes., Sp.B., FinaCS selaku pembimbing 1,

atas kesabaran, kebaikan hati, serta kesediaan dalam meluangkan waktu

dalam membimbing hingga dapat menyelesaikan penelitian ini dengan baik.

dr. Thontowi Djauhari N.S, M. Kes, selaku pembimbing 2, atas

kesabaran, kebaikan hati, serta kesediaan dalam meluangkan waktu dalam

membimbing penulis hingga dapat menyelesaikan penelitian ini dengan

baik.

viii

dr. Annisa’ Hasanah, M.Si., selaku penguji tugas akhir ini, atas segala

nasihat, masukan, dan arahan yang sangat bermanfaat dalam proses

penyelesaian tugas akhir ini dan kesediaan waktu beliau, sehingga tugas

akhir ini dapat diselesaikan dengan baik.

Kedua orang tua saya, yang tidak pernah lelah mendoakan, berikhtiar

dalam tirakatnya untuk saya, memberikan dukungan moril dan materiil, dan

senantiasa hadir dalam setiap detik perjuangan hidup saya.

Kakak saya, dr. Syailendra Fii Sulaiman, dan seluruh keluarga yang

senantiasa memberikan dukungan tak terputus kepada saya.

Sahabat-sahabat tercinta, Inas Khoirunnisa, Nungki Samahah, Amirah

Muhammad Abdullah, Elda Cintya, Mira Wiji Lestari, Galih Bayu Prakoso,

Umar Thalib, dan Azmiyah Febri yang telah sangat banyak membantu

proses penyelesaian tugas akhir ini hingga tidak dapat dijelaskan satu per

satu.

Seluruh staf TU dan laboran, Pak Yono, Bu Endah, Mba Citra, Mba

Nuke, Mas Miftah, Mas Nyono dan Pak Joko yang bersedia membantu

setiap tahapan proses penelitian hingga penyelesaian tugas akhir ini.

Sejawat FK UMM angkatan 2013, Gluteus Maximus, bantuan dan

kerjasamanya. Semoga kelak dapat menjadi dokter-dokter profesional yang

barokah, sukses dunia akhirat, dan senantiasa dalam ketaatan kepada Allah

SWT.

Semua pihak yang terlibat secara langsung maupun tidak langsung,

terima kasih atas bantuan dan dukungannya.

ix

DAFTAR ISI

Halaman

HALAMAN JUDUL ........................................................................................... i

KATA PENGANTAR ........................................................................................ ii

UCAPAN TERIMAKASIH .............................................................................. iii

ABSTRAK ....................................................................................................... viii

ABSTRACT ........................................................................................................ ix

DAFTAR ISI ........................................................................................................ x

DAFTAR TABEL.............................................................................................. xii

DAFTAR GAMBAR ........................................................................................ xiii

DAFTAR SINGKATAN .................................................................................. xiv

BAB 1 PENDAHULUAN .................................................................................. 1

1.1 Latar Belakang ................................................................................... 1 1.2 Rumusan Masalah .............................................................................. 3 1.3 Tujuan Penelitian ................................................................................ 3

1.3.1 Tujuan Umum ........................................................................... 3

1.3.2 Tujuan Khusus .......................................................................... 3

1.4 Manfaat Penelitian .............................................................................. 3

1.4.1 Manfaat Akademik .................................................................... 3

1.4.2 Manfaat Klinis ........................................................................... 3

1.4.3 Manfaat Masyarakat .................................................................. 4

BAB 2 TINJAUAN PUSTAKA .......................................................................... 5

2.1 Kulit.................................................................................................... 5 2.1.1 Anatomi Kulit Manusia ............................................................. 5 2.1.1.1 Epidermis ...................................................................... 5

2.1.1.2 Dermis ........................................................................... 7

2.1.1.3 Hipodermis atau Subkutis .............................................. 7

2.1.2 Fungsi Kulit ............................................................................... 8

2.1.3 Anatomi Kulit Tikus ............................................................... 11

2.2 Luka.................................................................................................. 13

2.2.1 Pembagian Jenis Luka ............................................................. 13

2.2.2 Penyembuhan Luka ................................................................. 15

2.2.3 Faktor Yang Mempengaruhi Penyembuhan Luka .................. 18

2.3 Kenikir.............................................................................................. 19

2.3.1 Klasifikasi Kenikir .................................................................. 19

2.3.2 Morfologi Kenikir ................................................................... 20

2.3.3 Kandungan Daun Kenikir ....................................................... 21

2.3.4 Quercetin dalam Kenikir ......................................................... 21

2.3.4.1 Pengaruh Quercetin Sebagai Antioksidan .................. 22

2.3.4.2 Pengaruh Quercetin Terhadap Penyembuhan Luka .... 23

2.4 Sediaan Gel ...................................................................................... 24

2.4.1 HPMC ..................................................................................... 25

BAB 3 KERANGKA KONSEPTUAL DAN HIPOTESIS PENELITIAN .. 26

3.1 Kerangka Konseptual Penelitian ...................................................... 26

3.2 Hipotesis Penelitian .......................................................................... 27

BAB 4 METODE PENELITIAN ..................................................................... 28

x

4.1 Jenis dan Rancangan Penelitian ....................................................... 28

4.2 Lokasi dan Waktu Penelitian ........................................................... 28

4.3 Populasi dan Sampel ........................................................................ 28

4.3.1 Populasi ................................................................................... 28

4.3.2 Sampel ..................................................................................... 28

4.3.3 Teknik Pengambilan Sampel ................................................... 28

4.3.4 Estimasi Besar Sampel ............................................................ 28

4.4 Karakteristik Sampel Penelitian ........................................................ 30

4.5 Variabel Penelitian ............................................................................ 30

4.6 Definisi Operasional .......................................................................... 31

4.7 Alat dan Bahan penelitian ................................................................. 32

4.7.1 Alat ........................................................................................... 32

4.7.2 Bahan ........................................................................................ 34

4.8 Prosedur Penelitian............................................................................ 35

4.9 Alur Penelitian .................................................................................. 41

4.10 Analisis Data ................................................................................... 41

BAB 5 HASIL PENELITIAN DAN ANALISIS DATA ................................ 43

5.1 Hasil Penelitian ................................................................................ 43

5.2 Analisis Data .................................................................................... 45

BAB 6 PEMBAHASAN .................................................................................... 47

BAB 7 KESIMPULAN DAN SARAN ............................................................. 53

7.1 Kesimpulan ...................................................................................... 53

7.2 Saran ................................................................................................. 53

DAFTAR PUSTAKA ........................................................................................ 54

LAMPIRAN ....................................................................................................... 57

xi

DAFTAR TABEL

Tabel

Halaman

2.1 Perbandingan Anatomi Kulit Tikus dan

Manusia.……...……….…………….11

2.2 Perbandingan Kandungan Tumbuhan

Kenikir….……………….…………….20

4.1 Formulasi

Gel.....................................................................................................37

4.2 Formulasi Basis Gel

..........................................................................................38

5.1 Data Luas Luka Eksisi Pada Tikus

Putih...........................................................43

5.2 Uji Normalitas Shapiro-

Wilk…………..............................................................46

5.3 Uji

Homogenitas.................................................................................................46

5.3 Uji Analisis Statistik

ANOVA...........................................................................47

5.3 Uji Post Hoc

Bonferroni.....................................................................................47

xii

DAFTAR GAMBAR

Gambar

Halaman

2.1 Anatomi Kulit

Manusia………………………………………………………..….8

2.2 Histologi Kulit

Tikus………………………………...……………….……....….12

2.3 Jenis

Luka……………………...…………………………………………......….14

2.4 Mekanisme Penyembuhan

Luka........................................................................... 18

2.5 Daun Kenikir (Cosmos Caudatus

H.B.K).............................................................20

2.5 Struktur

Quercetin.................................................................................................22

3.1 Kerangka Konseptual Peneliti..............................................................................

26

4.1 Biopsy Punch Medax Epitheasy diameter 5

mm...................................................33

4.2 Transparent Dressing

Tegaderm...........................................................................34

4.3 Alur

Penelitian.......................................................................................................41

xiii

5.1 Luas Luka Eksisi Tikus Putih Jantan hari ke

3......................................................44


6......................................................44


9......................................................44


12....................................................45


15....................................................45


18....................................................45


21....................................................45

DAFTAR SINGKATAN

CMC : Carboxymethyl cellulose

COX : Cyclooxigenase

EGF : Epidermal Growth Factor

HPMC : Hydroxypropil Methylcellulose

xiv

IGF : Insulin-like Growth Factor

LOX : Lypooxigenase

MMPs : Matrix Metalloproteinases

PDGF : Plateled-derived Growth Factor

PMN : Polymorphonuclear

ROS : Reactive Oxygen Species

TGF-β : Transforming Growth Factor Beta

TGF-β1 : Transforming Growth Factor Beta 1

VEGF : Vascular Endothelial Cell Growth Factor

xv

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