PERBANDINGAN PENGARUH CONTINUOUS LARGE STITCH DAN SMALL STITCH DENGAN BENANG NYLON TERHADAP EKSPRESI INTERLEUKIN 6 PADA GARIS INSISI KULIT ABDOMEN TIKUS ALBINO GALUR WISTAR (RATTUS NORVEGICUS)

WISNU DIPOYONO B W, dr. Imam Sofii, Sp.B-KBD .; Dr. dr. Ishandono Dachlan, MSc, Sp.B, Sp.BP-RE(K)

2020 | Tesis-Spesialis | ILMU BEDAH

Latar Belakang: Infeksi luka operasi adalah salah satu komplikasi pascaoperasi yang paling umum terjadi, paling sedikit 30-40% pada operasi abdomen. Luka insisi kulit ditutup untuk mengembalikan fungsi. Interleukin-6 memiliki peran penting dalam penyembuhan luka kulit, dengan mengatur akumulasi kolagen. Teknik yang digunakan untuk penutupan kulit mempengaruhi kualitas hasil luka. Tujuan: Untuk membandingkan teknik large stitch dengan small stitch pada untuk penutupan kulit abdomen. Metode: Dua puluh tikus digunakan pada dua kelompok. Kelompok small stitch dimana jahitan ditempatkan 5 mm dari tepi kulit dan kelompok large stitch ditempatkan 10 mm dari tepi kulit. Luka insisi kulit ditutup dengan jahitan kontinyu menggunakan nylon. Tikus didekapitasi pada hari ke-4 dan 7. Potongan jaringan diperiksa ekspresi IL-6 dengan imunohistokimia. Perbedaan rerata kelompok dianalisis dengan uji t. Hasil: Tikus pada kelompok large stitch memiliki ekspresi interleukin-6 yang lebih tinggi pada hari ke-4 dan 7 dibandingkan pada kelompok small stitch (38 [SD 18] vs 42 [12], p = 0,714, Cohens d = 0,24; 41 [SD 12] vs 45 [ 11], p = 0,650, Cohens d = 0,3). Ekspresi interleukin-6 pada kelompok small dan large stitch adalah 0,95 kali lipat lebih besar pada hari ke-7 daripada hari ke-4 (p = 0,999, Cohens d = 0,001). Kesimpulan: Kelompok large stitch mempunyai ekspresi interleukin-6 yang lebih tinggi daripada kelompok small stitch namun tidak signifikan secara statistik.

Background: Surgical site infection is one of the most common postoperative complications, occurring in at least 30-40% of patients undergoing abdominal surgery. Skin incisions need closure to restore function. Interleukin-6 has crucial roles in skin wound healing, by regulating collagen accumulation. Technique used for skin closure influences the quality of wound outcome. Aim: To compare the large stitch technique with the small stitch technique for abdominal skin closure. Methods: Twenty rats were used in two groups. The small stitch group received 5 mm small tissue bites and the large stitch group received 1 cm large bites. The incisions of skin were closed by running suture using nylon. After 4 and 7 days, animals were euthanized. Histological sections of the tissue-embedded sutures were subjected to IL-6 expression. The t tests were used to detect a statistical difference in two groups. Results: Rats in the large stitch group had higher interleukin-6 expression on days 4 and 7 than those in the small stitch group (38 [SD 18] vs 42 [12], p = 0,714, Cohens d = 0,24; 41 [SD 12] vs 45 [ 11], p = 0,650, Cohens d = 0,3). Interleukin- 6 expressions in both the small and large stitch group were 0,95-fold greater on day 7 than day 4 (p = 0,999, Cohens d = 0,001). Conclusion: The large stitch group achieve higher interleukin-6 expressions than the small stitch group but not significant statistically.

Kata Kunci : nylon, large stitch, small stitch, interleukin-6, penutupan kulit abdomen, nylon, large stitch, small stitch, interleukin-6, abdominal skin closure