Perbandingan Pengaruh Jahitan Teknik Simple Large Stitch dan Small Stitch dengan Benang Polyglecaprone 25 Terhadap Ekspresi Transforming Growth Factor Beta Pada Garis Insisi Kulit Abdomen Tikus Albino Galur Wistar

RINTANG RENGGANIS, dr. Imam Sofi'i, Sp.B_KBD; dr. Akhmad Makhmudi, Sp.B, Sp.BA (K)

2020 | Tesis-Spesialis | ILMU BEDAH

Latar Belakang: Teknik jahitan memiliki peranan penting dalam penutupan insisi laparotomi. Jarak jahitan dari tepi luka dan interval antar jahitan dapat mempengaruhi proses penyembuhan luka. Teknik large stitch dan small stitch merupakan teknik jahitan yang banyak digunakan. TGF-beta merupakan indikator penyembuhan luka yang memiliki peran penting pada proses penyembuhan luka. Tujuan: Mengetahui ekspresi TGF-beta pada teknik jahitan simple large stitch dan small stitch dengan benang polyglecaprone-25 pada insisi kulit abdomen tikus Rattus norvegicus Metode: Dua puluh tikus digunakan pada dua kelompok. Kelompok small stitch dilakukan dengan menempatkan jahitan simpel 5 mm dan kelompok large stitch 10 mm dari tepi kulit menggunakan polyglecaprone-25. Tikus didekapitasi pada hari ke 4 dan 7. Potongan jaringan diperiksa ekspresi TGF-beta dengan imunohistokimia Hasil: Ekspresi TGF-beta pada kelompok dengan teknik small stitch lebih tinggi dibandingkan kelompok large stitch. Hasil bermakna didapatkan pada hari ke-4 dimana rata rata ekspresi TGF-beta small stitch (105.47 +/-2.15) lebih tinggi dibandingkan dengan teknik large stitch (90.20+/-2.34) dengan p value 0.003. Hasil tidak bermakna pada ekspresi TGF-beta hari ke 7 dimana rata rata ekspresi TGF-beta pada kelompok large stitch yaitu 112.07+/-4.71 dan small stitch yaitu 116.47+/- 6.65 (P=0.154). Pada analisis effect size dengan cohen diketahui kelompok large stitch hari ke-7 memiliki ekspresi TGF-beta 0.068 standard deviasi lebih rendah dibandingkan dengan small stitch hari ke-7. Kesimpulan: Ekspresi TGF-beta pada kelompok small stitch lebih tinggi dari pada large stitch terutama pada hari ke-4. Ekspresi TGF-beta pada small stitch dan large stitch tidak berbeda pada hari ke-7. Kata kunci: polyglecaprone-25, large stitch, small stitch, TGF-beta, penutupan kulit abdomen

Background: : Suture techniques have an important role in closing laparotomy incisions. Suture distance from the edge of the wound and inter-suture intervals can affect the wound healing process. The technique of large stitch and small stitch is a widely used suture technique. TGF-beta is an indicator of wound healing which has an important role in the process of wound healing. Aim: To know the TGF-beta expression in the simple large stitch and small stitch suture technique with polyglecaprone-25 on the abdominal skin incision of Rattus norvegicus mice. Method: Twenty rats were used in two groups. The small stitch group is done by placing a simple suturing in 5 mm and 10 mm from the skin edge on large stitch group using polyvinylidene fluoride. Mice were decapitated on days 4 and 7. Tissue pieces were examined for TGF-beta expression with immunohistochemistry. Results: TGF-beta expression in the group with the small stitch technique was higher than the large stitch group. Significant results were obtained on day 4 where the average TGF-beta small stitch expression (105.47 +/- 2.15) was higher than the large stitch technique (90.20 +/-2.34) with p value 0.003. The results were not significant in TGF-beta expression on the 7th day where the average TGF-beta expression in the large stitch group was 112.07+/- 4.71 and the small stitch was 116.47+/- 6.65 (P = 0.154). In the analysis of the effect size with Cohen, Expression of TGF-beta of the large stitch group on the 7th day has 0.021 standard deviation lower than the small stitch on the 7th day Conclusion: TGF-beta expression in the small stitch group was higher than that of the large stitch, especially on the 4th day. TGF-beta expression on small stitch and large stitch did not differ on day 7. Keywords: polyglecaprone-25, large stitch, small stitch, TGF-beta, abdominal skin closure.

Kata Kunci : polyglecaprone-25, large stitch, small stitch, TGF-beta, penutupan kulit abdomen