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Hubungan waktu pemberian antibiotik profilaksis sebelum inflasi turniket pada operasi orthopaedi dengan kadar antibiotik dalam hapusan luka operasi dan resistensi bakteri terhadap cefazolin

Abstract

Background: Tourniquet is one of the modality commonly used in orthopaedic surgeries. The purpose of this research is to determine the optimal timing for prophylaxis antibiotic administration on surgery using tourniquet to produce maximum antibiotic concentration on the surgical site, and to determine antibiotic sensitivity of the bacteria cultured form the surgical site.

Methods: This research used analytic cross-sectional study design. A total of 24 samples are gathered using consecutive sampling method, who then are divided into three group. Inclusion criteria: orthopaedic surgery using tourniquet, and the use of cefazolin as prophylaxis antibiotic. Exclusion criteria: history of infection by cefazolin-resistant bacteria, history of chronic osteomyelitis on surgical site, and allergy to cefazolin.

Results: From the three sample group, group that receive cefazolin 30-45 minutes before tourniquet inflation gives the highest antibiotic concentration on the surgical site compared to 45-60 minutes and >60 minutes group (p=0.000). While on the antibiotic sensitivity test, no bacteria was grown on the surgical site swab sample, so the test cannot proceed.

Conclusion: The optimal timeframe for prophylaxis antibiotic administration is 30-45 minutes prior to tourniquet inflation. Surgical site bacterial growth can be prevented by antibiotic administration on the reccomended timeframe.

 

Latar Belakang: Turniket merupakan salah satu modalitas yang sering digunakan dalam operasi orthopaedi. Penelitian ini bertujuan untuk mencari waktu terbaik pemberian antibiotik profilaksis cefazolin sebelum inflasi turniket agar menghasilkan kadar antibiotik maksimal di luka operasi, dan melihat sensitivitas antibiotik bakteri apabila terdapat pertumbuhan bakteri pada swab luka operasi.

Metode: Penelitian ini menggunakan desain cross-sectional analitik. Subjek penelitian dibagi menjadi 3 kelompok waktu pemberian antibiotik. Kriteria inklusi pasien: operasi orthopaedi menggunakan turniket. Kriteria eksklusi sampel: memiliki riwayat infeksi dengan bakteri yang resisten terhadap cefazolin, riwayat osteomielitis kronik di lokasi operasi, dan alergi terhadap cefazolin.

Hasil: Dari ketiga kelompok pasien, didapatkan kadar antibiotik tertinggi pada luka operasi pada kelompok pemberian antibiotik 30- 45 menit sebelum inflasi turniket dibandingkan dengan pemberian Hubungan waktu pemberian antibiotik profilaksis sebelum inflasi turniket operasi dan resistensi bakteri terhadap cefazolin. Medicina 51(3): 555-559. 45-60 menit dan > 60 menit sebelum inflasi dengan perbedaan yang signifikan (p<0.000). Sedangkan pada pemeriksaan biakan bakteri untuk tes sensitivitas antibiotik, tidak ditemukan pertumbuhan bakteri pada kedua belas sampel,

Simpulan: Waktu pemberian antibiotik profilaksis yang optimal pada pasien yang menjalani operasi orthopaedi menggunakan turniket adalah 30-45 menit sebelum inflasi turniket. Pertumbuhan bakteri di luka operasi dapat dicegah melalui pemberian antibiotik profilaksis pada rentang waktu 30-60 menit.

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How to Cite

Ambong, H. A., Kawiyana, I. K. S., & Ridia, K. G. M. (2020). Hubungan waktu pemberian antibiotik profilaksis sebelum inflasi turniket pada operasi orthopaedi dengan kadar antibiotik dalam hapusan luka operasi dan resistensi bakteri terhadap cefazolin. Medicina, 51(3). https://doi.org/10.15562/medicina.v51i3.1025

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Hafidz Addatuang Ambong
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I Ketut Siki Kawiyana
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Ketut Gede Mulyadi Ridia
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