perawatan luka rasional idi nov 2015
TRANSCRIPT
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
1/62
1
Prof. Dr. David S Perdanakusuma, dr. SpBP-RE(K)
Departemen Bedah Plastik Rekonstruksi dan Estetik
Fakultas Kedokteran Universitas Airlangga- RSUD Dr. Soetomo
Surabaya Indonesia
PERAWATAN LUKAPERAWATAN LUKA
RASIONALRASIONAL
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
2/62
2
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
3/62
3
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
4/62
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
5/62
5
necrotic infection
granulation
epithelialization
sloughy
chronic wound
burn
fungating
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
6/62
LUKA :LUKA :TERPUTUSNYA KONTINUITAS JARINGANTERPUTUSNYA KONTINUITAS JARINGAN
E/ :
Trauma
PembedahanNeuropatik
Vascular
PenekananKeganasan
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
7/62
Klasifkasi Luka
Akut
Luka baru, mendadak danpenyembuhannya sesuai waktu ygdiperkirakan : Luka sayat, luka bakar,luka tusuk, crush injury
Kronik
Luka gagal sembuh pd waktu yg
diperkirakan, tidak berespon baik thdterapi dan punya tendensi untuk timbulkembali : ulkus tungkai, ulkusdiabetikum, ulkus dekubitus, lukabakar, kanker kulit.
Acute wound
Chroni c wound
!
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
8/62
" 21 3#
HemostasisInfamasi esench!ma" Ce""
i#rationPro"i$erasi
An#io#enesisE%ite"ia"isasi
Sintesis Ko"a#enKontra&si Lu&a
SintesisProteo#"!can
Remode""in#aturasi
A&ti'ita
sPen!em(uhan
Hari Sete"ah Lu&a1
Sintesis Ko"a#en)e#radasi Ko"a#en
PENYEMBUHAN LUKAPENYEMBUHAN LUKAUPAYA MEMPERBAIKI KERUSAKAN YANG TERJADI
FASE I INFLAMASI : VK, VD, AKUMULASI PMN, FIBRIN, MAKROFAG
FASE II PROLIFERASI, FIBROPLASI : GRANULASI, KOLAGENASI, EPITELIALISASIFASE III REMODELLING : PEMATANGAN PARUT
$
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
9/62%
&uka'embuh
TertutupEpitel
(((Tanpa Parut atau denganParut
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
10/621)
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
11/62
1* Preparasi bed luka
2* Penutupan luka
11
PRINSIP PENATALAKSANAAN LUKA
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
12/62
PREPARASI BED LUKA
1*+ebridement
2*Kontrol ,akteri -bacterialbalance.
3*Pengelolaan Eksudat
12
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
13/6213
Debridement
Membuang jaringan mati
Membersihkan jaringan yang terkontaminasi
Mempertahankan struktur penting semaksimal mungkin
Surgical debridement
Mechanical debridement
Autolytic debridement
Enzymatic debridement
Biological debridement
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
14/62
1"
SURGICAL DEBRIDEMENT
'harp debridement
'kalpel gunting kuret 0irigasi
Paling cepat dan eekti
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
15/62
1#
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
16/62
11
SUR*ICAL )E+RI)EENT
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
17/62
1!
ECHANICAL )E+RI)EENT
aue debridement 4et to dr5 dressing
aue 0 saline kering 6aringan mati terbuang
saat mengganti balut
7urettage
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
18/62
1$
AUTOL,TIC)E+RI)EENT
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
19/62
1%
ENZYMATIC DEBRIDEMENT
1%
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
20/62
2)
+IOLO*ICAL )E+RI)EENT
A**OT )E+RI)EENT THERAP,
21)/cm
2
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
21/62
21
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
22/62
22
Kontrol Bakteri
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
23/62
23
Su&ses tida&n!a %enutu%an "u&a ter#antun# adatida&n!a in$e&si
In$e&si "u&a ditentu&an &eseim(an#an da!atahan "u&a - .um"ah mi&roor#anisme
/ 012 3#ram tissue In$e&si 456 0123#ram tissue In$e&si 7856 0193#ram tissue *a#a":or an! "e'e" o$ ;
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
24/62
2"2"
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
25/62
2#
MMOISTURE BALANCEOISTURE BALANCE
Maserasi - DesikasiMaserasi - Desikasi
PENELOLAAN EKSUDAT
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
26/62
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
27/62
2!
Penutu%an Lu&aPenutu%an Lu&a
Sem(uh s%ontan3 %er
se&undam
1
Bahit %rimer3 %er%rimam2
S&in #ra$t3
?"a% "o&a""
?"a% .auh#
?ree fa% 3 (edahmi&ro
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
28/62
2$
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
29/62
2%
=ntiseptic : 7etrimide 7hlorhe>idine ?5drogenpero>ide 3; @odine
+5es : ,rilliant green entian Aiolet
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
30/62
3)
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
31/62
31
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
32/62
Grade II Superficial
Gr.II/ eschar
Necrotic
Grade III/ eschar bullae
+iagnosis C'amaD Tampilan C,edaD
32
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
33/62
Dia!nosis "Beda#- Tam$ilan "Sama#
PROBLEMLUKA
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
34/62
3"
PROBLEM LUKA
WARNALUKA
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
35/62
3#
WARNA LUKA
BASAHKERINGNYALUKA
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
36/62
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
37/62
Problem :Necrotic +
Infection -Exudate -
Surface : dry
Color : Black, Yellow
dry to moist
Gel
Courtesy : David S Perdanakusu3!
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
38/62
Problem :Necrotic +
Infection -Exudate + Surface : wet
Color : yellow, slough
wet to moist
Absorbtive product
Courtesy : David S Perdanakusu3$
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
39/62
Problem :raw surfaceNecrotic
Infection Exudate under control
Surface :wet / moist
Color : Red, pink
moist
Courtesy : David S Perdanakusu3%
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
40/62
")
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
41/62
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
42/62
urtesy : David S Perdanakusuma "2
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
43/62
Problem :infection exudate Necrotic ?
Acute Wound
"3
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
44/62
Courtesy : David S Perdanakusu
Problem :Necrotic +Infection -
Exudate +Surface : wet
Color : red
Problem :
Necrotic -Infection -Exudate +
Color : yellow
wet to moist
Absorbtive product
""
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
45/62
Courtesy : David S Perdanakusu"#
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
46/62
"
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
47/62
"!
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
48/62
"$ Courtesy : David S Perdanakusu
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
49/62
Bltrasonic 4ound
Treatment
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
50/62
Ne#ati'e Pressure Ther
%&A&C&' T(era$)%&A&C&' T(era$)
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
51/62
h5perbaric therap5
H d th i 3 hi " "
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
52/62
#2
H!drothera%i 3 whir"%oo"
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
53/62
Electrical 'timulation
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
54/62
#" Courtesy : David S Perdanakusu
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
55/62
## Courtesy : David S Perdanakusu
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
56/62
# Courtesy : David S Perdanakusu
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
57/62
#! Courtesy : David S Perdanakusu
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
58/62
#$ Courtesy : David S Perdanakusu
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
59/62
#% Courtesy : David S Perdanakusuma
+iabetic Blcer
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
60/62
) Courtesy : David S Perdanakusu
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
61/62
Penutup
1
Penilaian Luka : tidak hanya berdasarkan etiologi danklasifikasi. Penampilan Klinis : sangat penting dan bermanfaatuntuk penanganan luka.
Problem luka : infeksi, nekrotik, eksudat
Warna luka : hitam, kuning, kuning hijau, merah, pink
Kering basahnya permukaan luka : dibuat kondisi moist
Moist adalah kondisi luka yg ideal utk penyembuhan
Menentukan tindakan dan memilih dressing yang tepat
Evaluasi suatu modalitas terapi
-
7/25/2019 Perawatan Luka Rasional IDI Nov 2015
62/62
TEH@