Hasil Pencarian  ::  Simpan CSV :: Kembali

"Latar belakang: Semasa Pandemi COVID-19, Pemerintah Provinsi DKI Jakarta menetapkan RSKD Duren Sawit menjadi rumah sakit rujukan untuk merawat pasien COVID-19. Dan pada tahun 2022, RSKD Duren Sawit telah resmi mengadakan layanan kamar operasi. Akibat urgensi permintaan layanan kamar operasi yang lebih lengkap, penentuan tarif kamar operasi dilakukan dengan mengadaptasi tarif RSUD lain dan Peratuan Gubernur DKI Jakarta. Terdapat selisih biaya yang sangat besar antara tarif rumah sakit dan tarif klaim INA-CBGs, khususnya pada tindakan debridemen bedah yang dilakukan di kamar operasi. Salah satu faktor yang menyebabkan selisih biaya adalah belum ditetapkannya tarif tindakan debridemen berdasarkan komponen biaya satuan (unit cost). Tujuan: Mengetahui unit-cost debridemen di kamar operasi sesuai dengan biaya per-aktivitas. Metode: Desain penelitian ini adalah cohort retrospective. Aktivitas tindakan debridemen dikumpulkan melalui pengamatan langsung dan laporan operasi pasien. Kemudian melakukan perhitungan unit cost berdasarkan activity-based costing. Hasil: Unit cost tindakan debridemen dengan anastesi TIVA adalah Rp. 3.189.185, dengan anastesi spinal adalah Rp. 3.169.460, dan dengan anastesi blok perifer adalah Rp. 3.305.072. Kesimpulan: Hasil perhitungan unit cost lebih rendah dibandingkan tarif rumah sakit untuk tindakan debridemen leher dan mediastinitis. Namun untuk tindakan debridemen oleh bedah umum dan bedah mulut, unit cost lebih tinggi.

---

Background: During the COVID-19 Pandemic, The Government of DKI Jakarta established the Duren Sawit RSKD as a referral hospital to treat COVID-19 patients. And in 2022, RSKD Duren Sawit has officially held operating room services. Due to the urgency demand for more complete operating room services, the determination of operating room rates is carried out by adapting the other hospitals and The Governor Regulation of DKI Jakarta. There is a huge difference in costs between the hospital rates and the INA-CBGs claim rates, especially for surgical debridement performed in the operating room. One of the factors causing the difference is the undetermined cost for debridement based on the unit cost component. Objective: Knowing the unit-cost debridement in the operating room according to the cost per activity. Methods: The study design was a retrospective cohort. Debridement action activities were collected through direct observation and patient operation reports. Then perform unit cost calculations based on activity-based costing. Results: The unit cost of debridement with TIVA anesthesia is Rp. 3.189.185, with spinal anesthesia is Rp. 3.169.460, and with peripheral block anesthesia is Rp. 3.305.072. Conclusion: The unit cost calculation results are lower than hospital rates for neck debridement and mediastinitis. However, for debridement by general surgery and oral surgery, the unit cost is higher."

"Abses tuberkulosis spinal merupakan salah satu komplikasi serius dari infeksi tuberkulosis yang dapat menyebabkan kerusakan neurologis dan sulitnya eradikasi kuman. Tata laksana operatif dengan debridemen terbuka sering kali dipilih. Namun, teknik minimal invasif telah mulai dikembangkan, termasuk Teknik Evakuasi Abses Sistem Tertutup (EAST), meski datanya masih terbatas. Penelitian ini bertujuan untuk menilai luaran klinis dan laboratoris pada pasien yang menjalani EAST dibandingkan debridemen terbuka. Penelitian retrospektif ini melibatkan 48 pasien yang menjalani salah satu dari kedua teknik tersebut. Hasil menunjukkan bahwa EAST menghasilkan nyeri pascaoperasi lebih rendah (VAS 2 vs. 4; p<0,001) dan panjang jaringan parut lebih kecil (0 cm vs. 12 cm; p<0,001) dibandingkan debridemen terbuka. Durasi rawat inap lebih singkat secara median pada kelompok EAST, meski tidak signifikan (2 vs. 3 hari; p=0,06). Namun, angka rekurensi lebih tinggi pada teknik EAST (2 kasus vs. 0). Kedua teknik menunjukkan hasil serupa dalam kadar CRP dan Oswestry Disability Index (ODI). Hasil ini menunjukkan bahwa EAST menawarkan alternatif minimal invasif dengan hasil klinis lebih baik, tetapi memerlukan perhatian terhadap risiko rekurensi. Studi lebih lanjut diperlukan untuk memastikan temuan ini dan mengevaluasi keamanan jangka panjang teknik EAST.

---

Spinal tuberculosis abscess is one of the serious complications of tuberculosis infection that can lead to neurological damage and difficulty in eradicating the pathogen. Open debridement surgery is often chosen. However, minimally invasive techniques, including closed system abscess evacuation (CSAE), have been developed, although data remains limited. This study was conducted to evaluate the clinical and laboratory outcomes of patients undergoing CSAE compared to open debridement. This study aims to compare the clinical and radiological outcomes between the Closed Abscess Evacuation System (CSAE) technique and open debridement in spinal tuberculosis abscess cases. This retrospective study involved 48 patients who underwent one of the two techniques. Results showed that CSAE yielded lower postoperative pain (VAS 2 vs. 4; p<0.001) and smaller scar length (0 cm vs. 12 cm; p<0.001) compared to open debridement. Median hospital stay was shorter in the CSAE group, although not statistically significant (2 vs. 3 days; p=0.06). However, the recurrence rate was higher with CSAE (2 cases vs. 0). Both techniques showed similar results in C-reactive protein (CRP) levels and Oswestry Disability Index (ODI). These findings suggest that CSAE offers a minimally invasive alternative with better clinical outcomes but requires attention to the risk of recurrence. Further studies are needed to validate these findings and evaluate the long-term safety of the CSAE technique."

"Latar Belakang: Luka kaki diabetes merupakan salah satu komplikasi diabetes melitus dengan tingkat disabilitas, morbiditas, dan mortalitas yang tinggi. Sebanyak 15% pasien dengan luka kaki diabetes harus menjalani amputasi pada ekstremitas bawah. Selain risiko amputasi yang tinggi, kaki diabetes juga menimbulkan beban ekonomi bagi pasien yaitu sekitar 20% dari biaya pengobatan DM dihabiskan untuk perawatan luka kaki diabetes. Tujuan: Penelitian ini bertujuan untuk menganalisis hubungan HIF-1α, Leukosit, dan CRP pada Luka Kaki Diabetes yang menjalani Debridemen dan Amputasi, sehingga dapat dijadikan dasar dalam melakukan tata laksana yang tepat untuk pasien Luka kaki diabetes. Metode: Desain penelitian potong lintang (cross sectional). Subjek penelitian penderita luka kaki diabetes yang berobat ke RSUPN dr. Cipto Mangunkusumo, diambil data dasar (jenis kelamin dan usia), pemeriksaan klinis, pemeriksaan laboratorium (darah perifer lengkap, hitung jenis leukosit, glukosa darah, dan CRP). Selanjutnya biopsi jaringan luka kaki diabetes saat operasi debridement dan amputasi untuk pemeriksaan ekspresi HIF-1α secara biomolekular dengan pemeriksaan ELISA. Hasil: Subyek penelitian 30 pasien Luka kaki diabetes, amputasi 15 pasien dan debridemen 15 pasien. Usia rerata kelompok amputasi 51 tahun, dan kelompok debridement 54 tahun. Jenis kelamin laki-laki 50% dan perempuan 50%. Karakteristik laboratorium, GDS kelompok amputasi rerata 211 dan kelompok debridement 186. Laboratorium penanda inflamasi CRP dan Leukosit dua kelompok tidak didapatkan perbedaan bermakna (p>0.05). Ekspresi HIF-1α pada pemeriksaan Elisa didapatkan perbedaan bermakna antara kelompok amputasi dan debridement (p=0.007). Korelasi antara HIF-1α, Leukosit, dan CRP tidak signifikan. Nilai korelasi signifikan pada hubungan CRP dengan Leukosit, p <0,001. Kesimpulan: Didapatkan perbedaan signifikan ekspresi HIF-1α pada luka kaki diabetes yang dilakukan debridemen dan amputasi. Akan tetapi tidak ada korelasi yang signikan antara HIF-1α, leukosit, dan CRP pada pasien luka kaki diabetes yang dilakukan amputasi dan debridement.

---

Background: Diabetic foot ulcers are one of the complications of diabetes mellitus with high rates of disability, morbidity, and mortality. As much as 15% of patients with diabetic foot ulcers have to undergo lower extremity amputation. In addition to the high risk of amputation, diabetic foot also poses an economic burden for patients, because 20% of DM treatment costs is spent on treating diabetic foot wounds.

Objective: This study aims to analyze the relationship between HIF-1α, leukocyte count, and CRP in diabetic foot patients who had undergone debridement and amputation, to examine their value as biomarkers for appropriate management in diabetic foot ulcers patients. Methods: The research design was cross-sectional. The subjects of the study were patients with diabetic foot ulcers who were treated at Cipto Mangunkusumo General Hospital, the basic data were taken (gender and age), clinical examination, laboratory examination (complete peripheral blood, leukocyte count, blood glucose, and CRP). Furthermore, diabetic foot ulcers tissue biopsy during debridement and amputation surgery for biomolecular examination of HIF-1α expression by ELISA examination.

Results: The study subjects were 30 patients with diabetic foot ulcers, 15 patients for amputation and 15 patients for debridement. The mean age of the amputation group was 51 years, and the debridement group was 54 years. Gender is 50% male and 50% female. Laboratory characteristics, the mean GDS of the amputation group was 211 and the debridement group was 186. The laboratory inflammatory markers of CRP and Leukocytes did not show a significant difference (p>0.05). HIF-1α expression on Elisa's examination showed a significant difference between the amputation and debridement groups (p=0.007). The correlation between HIF-1α, Leukocytes, and CRP was not significant. The correlation value was significant on the relationship between CRP and Leukocytes, p < 0.001.

Conclusion: There was significant difference in the expressions of HIF-1α in diabetic foot ulcers patients treated with debridement compared to those who are tretated with amputation. However, there was no significant correlation between HIF-1α, leukocytes, and CRP in debridement compared to amputation patients. There was a significant correlation between the value of leukocyte count and CRP in diabetic foot ulcers patients who underwent amputation compared to debridement. "