Perbandingan Pengaruh simple largestitch dan small stitch dengan benang polyglecaprone 25 terhadap ekspresi interleukin-6 pada garis insisi kulit abdomen tikus albino galur wistar ( rattus norvegicus)

KENYA NISITA DAMAY P, Pembimbing 1 : dr. Imam Sofii, Sp.B-KBD ; Pembimbing 2 : Prof. Dr. dr. Yohanes W, Sp.KK

2020 | Tesis-Spesialis | ILMU BEDAH

Latar Belakang: Hernia insisional merupakan komplikasi laparotomi median yang sering terjadi. Disrupsi kulit menyebabkan hernia insisional. Fibroblas pada kulit, mensekresi interleukin-6. Interleukin-6 memiliki peran penting dalam proses penyembuhan luka. Teknik jahitan adalah salah faktor risiko penting dalam kejadian hernia insisional. Tujuan: Untuk membandingkan pengaruh large stitch dan small stitch pada 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 simple menggunakan polyglecaprone 25. 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 small stitch memiliki ekspresi interleukin-6 yang lebih tinggi pada hari ke 4 dan 7 dibandingkan pada kelompok large stitch (73 [SD 7] vs 60 [11], p = 0,045; 97 [SD 11] vs 72 [14], p = 0.012). Ekspresi interleukin-6 pada kelompok small stitch adalah 1,50 kali lipat lebih besar pada hari ke 7 dibanding hari ke 4 dan 1,18 kali lebih besar pada kelompok large stitch (p = 0,033). Kesimpulan: Kelompok small stitch mempunyai ekspresi kadar interleukin-6 yang lebih signifikan daripada kelompok large stitch secara statistik. Kata kunci: polyglecaprone 25, large stitch, small stitch, interleukin-6, penutupan kulit abdomen

Background: Incisional hernia is a frequent complication of midline laparotomy. Incisional hernia is the late complication of skin disruption. The fibroblast of the skin, secretes interleukin-6. Interleukin-6 has crucial roles in the wound-healing process. The suture technique is important determinant of the risk of developing an incisional hernia. 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 small tissue bites of 5 mm and the large stitch group received large bites of 1 cm. The incisions of skin were closed by running suture using polyglecaprone 25. Animals were euthanized on days 4 and 7. Histological sections of the tissue-embedded sutures were subjected to IL-6 expression. The differences were analyzed with t tests. Results: Rats in the small stitch group had higher interleukin-6 expression on days 4 and 7 than those in the large stitch group (73 [SD 7] vs 60 [11], p = 0,045; 97 [SD 11] vs 72 [14], p = 0.012). Interleukin-6 expressions in the small stitch group were 1.50-fold greater on day 7 than day 4 and were 1.18-fold greater in the large stitch group (p = 0.033). Conclusion: The small stitch group showed significantly higher interleukin-6 levels than the large stitch group. Keywords: polyglecaprone 25, large stitch, small stitch, interleukin-6, abdominal skin closure.

Kata Kunci : Kata kunci: polyglecaprone 25, large stitch, small stitch, interleukin-6, penutupan kulit abdomen