Bambang A. Sulthana
Departemen Bedah Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Dr. Hasan Sadikin Bandung

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Hubungan Lama Obstruksi Usus, Warna dan Kejernihan Cairan Peritoneum dengan Kontaminasi Bakteri pada Hernia Inkarserata Sidabutar, Unedo M. H.; Sulthana, Bambang A.; Lukman, Kiki
Majalah Kedokteran Bandung Vol 44, No 4 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (652.009 KB)

Abstract

Hernia inkarserata merupakan salah satu kasus abdomen akut yang diakibatkan obstruksi usus karena jepitan cincin. Penelitian eksperimental pada hewan coba membuktikan bahwa terjadi kerusakan barier mukosa setelah 4 jam obstruksi total usus dan kerusakan total setelah 12 jam, sehingga terjadi translokasi bakteri ke luar lumen usus. Untuk menentukan kontaminasi bakteri dalam kantung hernia akibat translokasi kuman, dilakukan pemeriksaan kultur dalam cairan peritoneum. Tujuan penelitian untuk mengetahui hubungan lama gejala obstruksi, warna, dan kejernihan cairan peritoneum dengan kontaminasi bakteri sebagai akibat translokasi kuman pad penderita hernia inkarserata. Waktu penelitian bulan Oktober 2009–Juli 2010 di Instalasi Gawat Darurat Bedah Rumah Sakit Dr. Hasan Sadikin Bandung. Dilakukan penelitian potong lintang yang menganalisis hubungan lama obstruksi usus, warna dan kejernihan cairan peritoneum dengan positivitas kultur bakteri. Penelitian dilakukan pada 40 penderita, 36 laki-laki dan 4 perempuan. Lama inkarserasi rata-rata adalah 7 jam. Terdapat 11 kasus dengan kultur positif, dengan jenis bakteri terbanyak Staphylococcus (27%). Analisis statistik dengan metode chi-kuadrat dan analisis regresi logistik berganda menunjukkan hubungan lama obstruksi dan perubahan warna cairan peritoneum dengan kontaminasi bakterial (p=0,015; p=0,001) dengan rasio prevalens lama obstruksi >7 jam sebesar 3,63, namun tidak terdapat hubungan dengan kejernihan cairan peritoneum (p=0,078). Penelitian ini tidak dapat menentukan cut-off time karena tidak mengikuti perjalanan penyakit, namun belum dapat dibuktikan translokasi bakteri karena kultur yang didapat adalah kuman komensal kulit. Simpulan, terdapat hubungan lama obstruksi usus dan perubahan warna cairan peritoneum dengan kontaminasi bakteri pada hernia inkarserata, tetapi tidak terdapat hubungan dengankejernihan cairan peritoneum dan kultur bakteri positif dengan kuman kontaminan kulit tidak dapat membuktikan translokasi kuman pada penderita hernia inkarserata. [MKB. 2012;44(4):199–204].Kata kunci: Hernia inkarserata, kontaminasi bakteri, lama obstruksi usus, warna dan kejernihan cairan peritoneumRelationship Bowel Obstructions Color and Clarity of Peritoneal Fluid with Bacterial Culture in Incarcerated HerniaIncarcerated hernia is an acute abdominal case caused by bowel obstruction due to incarceration of hernia ring. An experimental study on animals proved that there was mucosal barrier damage after 4 hours of total bowel obstruction and total damage after 12 hours causing bacterial translocation. In order to determine contamination due to bacterial translocation in the hernia sac, culture was taken from the peritoneal fluid. A cross-sectional study in Dr. Hasan Sadikin Hospital Bandung was done during October 2009 to July 2010 to analyze the relationship between duration of obstruction, color and clarity of peritoneal fluid, and bacterial culture. There were 40 patients, 36 males and 4 females involved in this study. Mean incarceration time was 7 hours. There were 11 positive culture cases, mostly Staphylococcus species (27%). Statistical analysis with chi-square and multiple logistic regression test showed that there was correlation between duration of obstruction and color and clarity of peritoneal fluid with bacterial contamination (p=0.015, p=0.001) with prevalence ratio of >7 hours length obstruction was 3.63, but not with clarity (p=0.078). In this study we could not obtain exact cut-off time of bowel obstruction’s period with bacterial translocation because it did not follow the pathologic event. In conclusions, there is correlation between duration of obstruction, color and clarity of peritoneal fluid with bacterial contamination, but bacterial translocation can not be proven because only commensal bacteria of the skin was obtained from the culture. [MKB. 2012;44(4):199–204].Key words: Bacterial contamination, color and clarity of peritoneal fluid, duration of obstruction, incarcerated hernia DOI: http://dx.doi.org/10.15395/mkb.v44n4.175
Sliding genioplasty pada penatalaksanaan deformitas dagu Supriyanto, Edi; Arumsari, Asri; Sulthana, Bambang A.
Journal of Dentomaxillofacial Science Vol 8, No 2 (2009): Formerly Jurnal Dentofasial ISSN 1412-8926
Publisher : DiscoverSys Inc

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Abstract

Chin contour and position is important component in facial balance. Deformities ofchin may occur as isolation deformity or associated with other dentofacialdeformities. This is a case report of 15-year old girl with chief complaint of chindeformity, and sliding genioplasty has been performed without any complication.
Penatalaksanaan fraktur mandibula pada anak menggunakan teknik circumferential wiring dengan Gunning splint Management of mandibular fracture in children using circumferential technique with Gunning splint Haryoseno, S.; Yuza, Abel Tasman; Sulthana, Bambang A.
Journal of Dentomaxillofacial Science Vol 11, No 2 (2012): Formerly Jurnal Dentofasial ISSN 1412-8926
Publisher : DiscoverSys Inc

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/jdmfs.v11i2.326

Abstract

Fractures of the mandible in children most commonly occur in the condyle and angulus. Circumferential wiring andGunning splint as a supporting tool to strengthen the fixation of the lower jaw. This case reported a 7 year-old-boywho had fracture of his right mandibular corpus. At the time of surgery, it was applied mini plate 5 holes and 4screws on the right mandibular corpus with the using of circumferential wiring on the right and left mandibularcorpus and symphysis, with Gunning splints. The patient was in good condition after surgery without complications
Hubungan Lama Obstruksi Usus, Warna dan Kejernihan Cairan Peritoneum dengan Kontaminasi Bakteri pada Hernia Inkarserata Sidabutar, Unedo M. H.; Sulthana, Bambang A.; Lukman, Kiki
Majalah Kedokteran Bandung Vol 44, No 4 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (652.009 KB)

Abstract

Hernia inkarserata merupakan salah satu kasus abdomen akut yang diakibatkan obstruksi usus karena jepitan cincin. Penelitian eksperimental pada hewan coba membuktikan bahwa terjadi kerusakan barier mukosa setelah 4 jam obstruksi total usus dan kerusakan total setelah 12 jam, sehingga terjadi translokasi bakteri ke luar lumen usus. Untuk menentukan kontaminasi bakteri dalam kantung hernia akibat translokasi kuman, dilakukan pemeriksaan kultur dalam cairan peritoneum. Tujuan penelitian untuk mengetahui hubungan lama gejala obstruksi, warna, dan kejernihan cairan peritoneum dengan kontaminasi bakteri sebagai akibat translokasi kuman pad penderita hernia inkarserata. Waktu penelitian bulan Oktober 2009–Juli 2010 di Instalasi Gawat Darurat Bedah Rumah Sakit Dr. Hasan Sadikin Bandung. Dilakukan penelitian potong lintang yang menganalisis hubungan lama obstruksi usus, warna dan kejernihan cairan peritoneum dengan positivitas kultur bakteri. Penelitian dilakukan pada 40 penderita, 36 laki-laki dan 4 perempuan. Lama inkarserasi rata-rata adalah 7 jam. Terdapat 11 kasus dengan kultur positif, dengan jenis bakteri terbanyak Staphylococcus (27%). Analisis statistik dengan metode chi-kuadrat dan analisis regresi logistik berganda menunjukkan hubungan lama obstruksi dan perubahan warna cairan peritoneum dengan kontaminasi bakterial (p=0,015; p=0,001) dengan rasio prevalens lama obstruksi >7 jam sebesar 3,63, namun tidak terdapat hubungan dengan kejernihan cairan peritoneum (p=0,078). Penelitian ini tidak dapat menentukan cut-off time karena tidak mengikuti perjalanan penyakit, namun belum dapat dibuktikan translokasi bakteri karena kultur yang didapat adalah kuman komensal kulit. Simpulan, terdapat hubungan lama obstruksi usus dan perubahan warna cairan peritoneum dengan kontaminasi bakteri pada hernia inkarserata, tetapi tidak terdapat hubungan dengankejernihan cairan peritoneum dan kultur bakteri positif dengan kuman kontaminan kulit tidak dapat membuktikan translokasi kuman pada penderita hernia inkarserata. [MKB. 2012;44(4):199–204].Kata kunci: Hernia inkarserata, kontaminasi bakteri, lama obstruksi usus, warna dan kejernihan cairan peritoneumRelationship Bowel Obstructions Color and Clarity of Peritoneal Fluid with Bacterial Culture in Incarcerated HerniaIncarcerated hernia is an acute abdominal case caused by bowel obstruction due to incarceration of hernia ring. An experimental study on animals proved that there was mucosal barrier damage after 4 hours of total bowel obstruction and total damage after 12 hours causing bacterial translocation. In order to determine contamination due to bacterial translocation in the hernia sac, culture was taken from the peritoneal fluid. A cross-sectional study in Dr. Hasan Sadikin Hospital Bandung was done during October 2009 to July 2010 to analyze the relationship between duration of obstruction, color and clarity of peritoneal fluid, and bacterial culture. There were 40 patients, 36 males and 4 females involved in this study. Mean incarceration time was 7 hours. There were 11 positive culture cases, mostly Staphylococcus species (27%). Statistical analysis with chi-square and multiple logistic regression test showed that there was correlation between duration of obstruction and color and clarity of peritoneal fluid with bacterial contamination (p=0.015, p=0.001) with prevalence ratio of >7 hours length obstruction was 3.63, but not with clarity (p=0.078). In this study we could not obtain exact cut-off time of bowel obstruction’s period with bacterial translocation because it did not follow the pathologic event. In conclusions, there is correlation between duration of obstruction, color and clarity of peritoneal fluid with bacterial contamination, but bacterial translocation can not be proven because only commensal bacteria of the skin was obtained from the culture. [MKB. 2012;44(4):199–204].Key words: Bacterial contamination, color and clarity of peritoneal fluid, duration of obstruction, incarcerated hernia DOI: http://dx.doi.org/10.15395/mkb.v44n4.175