Kahdar Wiriadisastra
Department of Neurosurgery, Universitas Padjadjaran, Hasan Sadikin Hospital, Bandung, Indonesia

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Efficacy of Profilactic and Therapeutic Antibiotic in Congenital Hydrocephalus Shunt Infection Imron, Akhmad; Wiriadisastra, Kahdar
Journal of Medicine and Health Vol 1, No 1 (2015)
Publisher : Maranatha Christian University

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Abstract

Prophylactic dose antibiotic are indicated in patients having neurosurgical clean operations with implant surgery. The aim of this study is to evaluate the efficacy of prophylactic dose antibiotic in shunt infection. Between 1 October 2009 until 31 September 2011, 102 patients with congenital hydrocephalus who underwent VP shunt surgery. Fifty-one received profilactic antibiotic (ceftriaxone 50-75 mg/kgBW), 30-60 minutes before surgery until 5 days post-operative, and 51 patients received therapeutic antibiotic  (ceftriaxone 50-75 mg/kgBW), 30-60 minutes before surgery until 1 days post-operative. All patient were followed for 1-6 months to evaluate shunt infection. Collected data will be statistically analyzed. The study found that the rate of infection is 17,6% (9 patients of 51 patients) who received therapeutic antibiotic, and 17,6% (9 patients of 51 patients) who received profilactic antibiotic.There is not statistically significant between all group in shunt infection (p=1,000). Others risk factors significantly influence shunt infection are enlargement of the head (p=0,002), length of surgery (p=0,00327), time of surgery (p=0,00077) and nutrition status (p=0,01343). The results of this study indicate that profilactic antibiotic effective to prevent shunt infection in congenital hydrocephalus. Others risk factors significantly influence are enlargement of the head, length of surgery, time of surgery and nutrition status. Keywords:  antibiotic,  prophylactic, infection, VP shunt, congenital hydrocephalus
Efficacy of Profilactic and Therapeutic Antibiotic in Congenital Hydrocephalus Shunt Infection Imron, Akhmad; Wiriadisastra, Kahdar
Journal of Medicine & Health Vol 1 No 1 (2015)
Publisher : Universitas Kristen Maranatha

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Abstract

Prophylactic dose antibiotic are indicated in patients having neurosurgical clean operations with implant surgery. The aim of this study is to evaluate the efficacy of prophylactic dose antibiotic in shunt infection. Between 1 October 2009 until 31 September 2011, 102 patients with congenital hydrocephalus who underwent VP shunt surgery. Fifty-one received profilactic antibiotic (ceftriaxone 50-75 mg/kgBW), 30-60 minutes before surgery until 5 days post-operative, and 51 patients received therapeutic antibiotic  (ceftriaxone 50-75 mg/kgBW), 30-60 minutes before surgery until 1 days post-operative. All patient were followed for 1-6 months to evaluate shunt infection. Collected data will be statistically analyzed. The study found that the rate of infection is 17,6% (9 patients of 51 patients) who received therapeutic antibiotic, and 17,6% (9 patients of 51 patients) who received profilactic antibiotic.There is not statistically significant between all group in shunt infection (p=1,000). Others risk factors significantly influence shunt infection are enlargement of the head (p=0,002), length of surgery (p=0,00327), time of surgery (p=0,00077) and nutrition status (p=0,01343). The results of this study indicate that profilactic antibiotic effective to prevent shunt infection in congenital hydrocephalus. Others risk factors significantly influence are enlargement of the head, length of surgery, time of surgery and nutrition status. Keywords:  antibiotic,  prophylactic, infection, VP shunt, congenital hydrocephalus
Anterior Transpetrosal Untuk Lesi pada Fosa Kranialis Media dan Posterior: Review Literatur dan Diseksi Kadaver Arifin, Muhammad Zafrullah; Sutiono, Agung Budi; Faried, Ahmad; Kawase, Takeshi; Wirjomartani, Beny Atmadja; Wiriadisastra, Kahdar
Majalah Kedokteran Bandung Vol 42, No 2 (2010)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Reseksi selektif pada bagian anterior piramid os petrosus (segitiga Kawase), dengan terlebih dahulu melakukan kraniotomi pada dinding lateral fosa kranialis media, dapat memberikan lapang pandang bedah yang cukup luas dari parasellar, clivus dan cerebellopontine angle (CPA), tanpa mengorbankan struktur organ pendengaran dalam (internal acoustics organ). Keuntungan utama teknik anterior transpetrosal ini adalah dapat langsung mengakses tumor yang melekat pada klivus melalui rongga kecil yang dibuat pada apeks os petrosus. Pengangkatan tumor dengan perdarahan yang minimal dapat dicapai dengan melakukan koagulasi pada arteri tentorium dan akses langsung ke arah anterior kanalis auditorius internus, juga dapat mengurangi cedera pada nervus fasialis dan vestibulokoklearis. Keuntungan lainnya, yaitu, rendahnya risiko komplikasi perdarahan vena, karena teknik ini tidak mengekspos sinus sigmoid ataupun vena Labbe. [MKB. 2010;42(2):86-91].Kata kunci: Anterior transpetrosal, fosa media dan posterior, diseksi kadaverAnterior Transpetrosal for Lession in Middle and Posterior Fossa: Literature Review and Cadaver DissectionResection of the anterior part of pyramid through the middle fossa craniotomy will give us a surgical field of the parasellar, clivus and cerebellopontine angle without sacrificing the auditory structure. The advantage of the anterior transpetrosal approach is the direct access to tumors that attached to the clivus via a keyhole created on the petrosus apex. Bloodless tumor removal can be achieved by detachment of the tentorial artery and direct access of the anterior internal auditory canal also can minimize the injury of the cranial nerve facialis and vestibulocochlearis. Another advantage is the low risk of venous damages since this approach is not exposing the sigmoid sinus and the vein of Labbe. [MKB. 2010;42(2):86-91].Key words: Anterior transpetrosal, middle and posterior fossa, cadaver dissection DOI: http://dx.doi.org/10.15395/mkb.v42n2.219