PENGARUH CHLORHEXIDINE 0,2% DAN POVIDONE IODINE 10% PADA LUKA TERBUKA TERHADAP SEL RADANG, PROLIFERASI SEL, DAN SEL APOPTOSIS

BENNY WIDIANTO, drg. Rahardjo, SU,Sp.BM

2015 | Tesis | SP ILMU BEDAH MULUT

Chlorhexidine 0,2% dan povidone iodine 10% merupakan larutan antiseptik spektrum luas dan sering digunakan pada bedah mulut tetapi dilaporkan bersifat toksik terhadap sel yang berperan dalam proses penyembuhan. Tujuan penelitian: untuk membandingkan pengaruh pemberian antiseptik chlorhexidine 0,2% dan povidone iodine 10% sebagai bahan irigasi pada luka terbuka terhadap sel radang, proliferasi sel, dan sel apoptosis. Metode penelitian: Tiga puluh enam tikus Sprague dawley dilukai pada punggung sepanjang 20 mm, lebar 5 mm, dan sedalam subkutan kemudian dibagi menjadi 3 kelompok. Tiap kelompok diirigasi menggunakan chlorhexidine 0,2%, povidone iodine 10%, dan saline sebagai kontrol sebanyak 10 ml selama 60 detik. Enam ekor tikus pada tiap kelompok didekapitasi dan dilakukan nekropsi pada hari ke-4 dan ke-7. Jaringan kulit yang dilukai dibuat preparat histologis kemudian dilakukan pengecatan Hematoksilin eosin untuk melihat sel radang, imunohistokimia Proliferating Cell Nuclear Antigen untuk melihat proliferasi sel, imunohistokimia Caspase 3 aktif untuk melihat sel apoptosis. Hasil penelitian: penggunaan chlorhexidine 0,2% pada hari ke-4 menunjukkan jumlah sel radang yang lebih banyak (p<0,05) dan pada hari ke-7 proliferasi sel lebih tinggi (p<0,05) dibandingkan povidone iodine 10% dan saline. Penggunaan povidone iodine 10% dan saline tidak terdapat perbedaan (p>0,05) terhadap jumlah sel radang dan proliferasi sel. Penggunaan ketiga bahan irigasi tersebut menunjukkan tidak terdapat perbedaan (p>0,05) terhadap sel apoptosis. Kesimpulan: penggunaan chlorhexidine 0,2% menunjukkan rerata jumlah sel radang lebih banyak dan rerata skor proliferasi sel lebih rendah dibandingkan povidone iodine 10% dan saline sebagai bahan irigasi pada luka terbuka.

0.2% chlorhexidine and 10% povidone iodine are broad spectrum antiseptic solution and often used in maxillofacial surgery; however, they are reported to be toxic against cells playing role in recovery process. Purpose: to compare the antiseptic application effect of 0.2% chlorhexidine and 10% povidone iodine as irrigation material on an open cut towards inflammation cells, cell proliferation and apoptotic cells. Method: Thirty six Sprague dawley mice were cut on the back by 20 mm in length and 5 mm in width and as deep as subcutaneous and then divided into three groups. Each group was irrigated using 0.2% chlorhexidine, 10% povidone iodine, and saline as control by 10 ml for 60 seconds. Six mice in each group were decapitated and necropsy was performed on 4th and 7th day. The cut skin tissue was histology prepared and it was then performed hematoxylin eosin staining to find out inflammation cells, immunohistochemistry Proliferating Cell Nuclear Antigen to see cell proliferation, and active 3 Caspase to find out the apoptotic cells. Result: 0.2% chlorhexidine administration on 4th day showed that there were more inflammation cells (p<0.05) and on the 7th day, cell proliferation were higher (p<0.05) compare to that of 10% povidone iodine and saline. There were no difference (p>0.05) in the usage of 10% povidone iodine and saline towards the number of inflammation and proliferation cells. There were no difference (p>0.05) in the application of all three irrigation materials toward apoptotic cells. Conclusion: the administration of 0.2% chlorhexidine suggested that there was more average number of inflammation cells and lower score average of proliferation cells compare to 10% povidone iodine and saline as irrigation material in an open cut.

Kata Kunci : povidone iodine 10%, chlorhexidine 0,2%, saline, sel radang, proliferasi sel, sel apoptosis, Proliferating Cell Nuclear Antigen, Caspase 3 aktif.