i

KARYA TULIS AKHIR

PERBEDAAN LAMA PENYEMBUHAN LUKA SIRKUMSISI

BERDASARKAN INDEKS MASSA TUBUH

Oleh:

ZULVIA SABILLAH PUTRI

201510330311058

UNIVERSITAS MUHAMMADIYAH MALANG

FAKULTAS KEDOKTERAN

2019

ii

HASIL PENELITIAN

PERBEDAAN LAMA PENYEMBUHAN LUKA SIRKUMSISI

BERDASARKAN INDEKS MASSA TUBUH

KARYA TULIS AKHIR

Diajukan kepada

Universitas Muhammadiyah Malang

untuk Memenuhi Salah Satu Persyaratan

dalam Menyelesaikan Program Sarjana

Fakultas Kedokteran

Oleh:

ZULVIA SABILLAH PUTRI

201510330311058

UNIVERSITAS MUHAMMADIYAH MALANG

FAKULTAS KEDOKTERAN

2019

i

ii

iii

iv

KATA PENGANTAR

Assalamu’alaikum Warahmatullah Wabarakatuh

Alhamdulillahi rabbil aalamiin, Atas nikmat Allah Subhanahu Wa Ta’ala yang

Maha Pengasih dan Maha Penyayang, penulisan tugas akhir ini dapat selesai

dengan baik. Shalawat serta salam selalu tercurahkan kepada Rasulullah

Muhammad shalallahu alaihi wassalam, keluarganya dan para sahabatnya yang

telah berjasa membawa syiar dakwah Islam ke seluruh dunia.

Penelitian tugas akhir ini berjudul “Perbedaan Lama Penyembuhan Luka

Sirkumsisi berdasarkan Indeks Massa Tubuh”. Tugas akhir ini diajukan untuk

memenuhi persyaratan Pendidikan Sarjana Fakultas Kedokteran Universitas

Muhammadiyah Malang.

Penulis menyadari bahwa tugas akhir ini masih jauh dari kata sempurna, oleh

karena itu, penulis sangat mengharapkan saran dan masukan yang membangun.

Semoga karya tulis ini dapat menambah wawasan keilmuan dan bermanfaat bagi

semua pihak.

Wassalamu’alaikum Warahmatullah Wabarakatuh

Malang, 19 Juni 2019

Penulis

v

UCAPAN TERIMA KASIH

1. Allah SWT yang telah memberikan rahmat, karunia kesehatan, kesabaran dan

lindungan sehingga penulis dapat menyelesaikan tugas akhir ini.

2. Kedua orangtua tercinta, ayahku dr. H. Imam Khudori dan ibuku Umi Nur

Azizah, SP, MMA serta adik-adikku tersayang, Muhammad Fakhrizal,

Fauziah Luthfinnadia, dan Khalisa Althafani, atas cinta dan kasih sayang,

dukungan, serta doa yang tak pernah putus dalam setiap proses yang peneliti

jalani hingga tugas akhir ini dapat terselesaikan dengan lancar.

3. Dr. dr. Meddy Setiawan, Sp.PD, FINASIM, selaku Dekan Fakultas

Kedokteran Universitas Muhammadiyah Malang.

4. dr. Mochamad Ma’roef, Sp.OG., selaku Wakil Dekan I Fakultas Kedokteran

Universitas Muhammadiyah Malang

5. dr. Sri Adilla Nurainiwati, Sp.KK., selaku Wakil Dekan II Fakultas

Kedokteran Universitas Muhammadiyah Malang.

6. dr. Indra Setiawan, Sp.THT-KL., selaku Wakil Dekan III Fakultas

Kedokteran Universitas Muhammadiyah Malang

7. dr. Mochammad Aleq Sander M,Kes, Sp.B., FINACS selaku Pembimbing I,

atas kesabaran, kebaikan hati, serta kesediaan dalam meluangkan waktu

selama membimbing penulis sehingga dapat menyelesaikan penelitian ini

dengan baik.

8. Dr. dr. Fathiyah Safithri, M.Kes selaku Pembimbing II, atas kesabaran,

kebaikan hati, serta kesediaan dalam meluangkan waktu selama membimbing

penulis sehingga dapat menyelesaikan penelitian ini dengan baik.

vi

9. dr. Gita Sekar Prihanti, M.PdKed selaku Penguji, atas segala masukan dan

arahan demi kesempurnaan tugas akhir ini

10. Seluruh staff TU, Bu Endah, Pak Heri, Mbak Citra, Mas Nyono, Pak Joko

dan Bu Fat serta Mbak Deva yang bersedia membantu setiap tahapan proses

penelitian hingga penyelesaian tugas akhir ini.

11. Ragil Mu’allimah, sahabat yang selalu mengirimkan semangatnya dari jauh,

sehingga penulis selalu ingat bahwa karya tulis ini harus segera penulis

selesaikan.

12. Fadhillah Ainnurohmah, Ikmalun Natiq, Novia Rahmawardani, yang selalu

memberikan bantuan, dukungan dan semangat serta doa dalam proses

penyelesaian tugas akhir ini.

13. Saudara-saudara TBMM diklat 13 dan seluruh anggota yang lainnya atas

dukungan, bantuan, dan doa yang senantiasa diberikan dalam penyelesaian

tugas akhir ini.

14. Sejawat FK UMM angkatan 2015, Metacarpalis, atas dukungan, bantuan dan

kerjasama yang terjalin satu sama lain.

15. Stray Kids, yang selalu memotivasi penulis saat jatuh bangun dalam proses

penulisan melalui pesan dalam lagu-lagunya dalam proses penyelesaian tugas

akhir ini.

16. Semua pihak yang terlibat secara langsung maupun tidak langsung dalam

penyelesaian tugas akhir ini, penulis menyampaikan terima kasih.

Penulis

ix

DAFTAR ISI

Halaman

LEMBAR PENGESAHAN ................................................................................ i

PERNYATAAN ORISINALITAS ..................................................................... ii

LEMBAR PENGUJIAN ..................................................................................... iii

KATA PENGANTAR ........................................................................................ iv

UCAPAN TERIMA KASIH ............................................................................... v

ABSTRAK .......................................................................................................... vii

ABSTRACT .......................................................................................................... viii

DAFTAR ISI ....................................................................................................... ix

DAFTAR TABEL ............................................................................................... xii

DAFTAR GAMBAR .......................................................................................... xiii

DAFTAR SINGKATAN .................................................................................... xiv

DAFTAR LAMPIRAN ....................................................................................... xv

BAB 1 PENDAHULUAN ................................................................................ 1

1.1 Latar Belakang ................................................................................ 1

1.2 Rumusan Masalah ........................................................................... 2

1.3 Tujuan Penelitian ............................................................................ 2

1.3.1 Tujuan Umum ........................................................................ 2

1.3.2 Tujuan Khusus ....................................................................... 3

1.4 Manfaat Penelitian .......................................................................... 3

BAB 2 TINJAUAN PUSTAKA ....................................................................... 4

2.1 Sirkumsisi ....................................................................................... 4

2.1.1 Pengertian Sirkumsisi ............................................................ 4

2.1.2 Tujuan Sirkumsisi .................................................................. 5

2.1.3 Indikasi Sirkumsisi ................................................................ 5

2.1.4 Kontraindikasi Sirkumsisi...................................................... 8

2.1.5 Metode Sirkumsisi ................................................................. 9

2.1.6 Komplikasi Sirkumsisi ........................................................... 11

2.1.7 Perawatan Pasca Sirkumsisi .................................................. 13

2.2 Penyembuhan Luka ......................................................................... 16

x

2.2.1 Fisiologi Penyembuhan Luka ................................................ 16

2.2.2 Faktor yang Mempengaruhi Kecepatan Penyembuhan Luka 17

2.2.3 Kriteria Penyembuhan Luka Sirkumsisi ................................ 18

2.3 Pengaruh Obesitas terhadap Penyembuhan Luka ........................... 20

2.4 Indeks Massa Tubuh (IMT) ............................................................ 22

2.4.1 Pengertian IMT ...................................................................... 22

2.4.2 Komponen IMT ..................................................................... 23

2.4.3 Cara Menghitung IMT ........................................................... 24

2.4.4 Faktor yang Mempengaruhi IMT .......................................... 28

2.4.5 Kelebihan dan Kekurangan IMT ........................................... 30

BAB 3 KERANGKA KONSEP DAN HIPOTESIS ......................................... 32

3.1 Kerangka Konsep ............................................................................ 32

3.2 Hipotesis Penelitian ........................................................................ 34

BAB 4 METODE PENELITIAN...................................................................... 35

4.1 Jenis Penelitian................................................................................ 35

4.2 Lokasi dan Waktu Penelitian .......................................................... 35

4.3 Populasi dan Sampel Penelitian ...................................................... 35

4.3.1 Populasi .................................................................................. 35

4.3.2 Sampel ................................................................................... 35

4.3.3 Besar Sampel ......................................................................... 35

4.3.4 Teknik Pengambilan Sampel ................................................. 36

4.3.5 Karakteristik Sampel Penelitian............................................. 36

4.3.6 Variabel Penelitian ................................................................. 37

4.3.7 Definisi Operasional .............................................................. 37

4.4 Alat dan Bahan Penelitian ............................................................... 39

4.5 Prosedur Penelitian ......................................................................... 39

4.6 Alur Penelitian ................................................................................ 40

4.7 Analisis Data ................................................................................... 40

4.8 Jadwal Penelitian ............................................................................ 41

BAB 5 HASIL PENELITIAN .......................................................................... 42

5.1 Hasil Penelitian ............................................................................... 42

5.2 Analisis Data ................................................................................... 44

xi

BAB 6 PEMBAHASAN ................................................................................... 46

BAB 7 KESIMPULAN DAN SARAN............................................................. 50

7.1 Kesimpulan ..................................................................................... 50

7.2 Saran ............................................................................................... 50

DAFTAR PUSTAKA ......................................................................................... 51

LAMPIRAN ........................................................................................................ 55

xii

DAFTAR TABEL

Halaman

2.1 Kategori Indeks Massa Tubuh Menurut WHO ...................................... 24

2.2 Kategori Indeks Massa Tubuh Menurut Depkes RI ............................... 25

2.3 Kategori Indeks Massa Tubuh pada Anak-Anak dan Remaja ............... 28

4.1 Definisi Operasional............................................................................... 37

4.2 Jadwal Penelitian .................................................................................... 41

5.1 Indeks Massa Tubuh Pasien Sirkumsisi ................................................. 42

5.2 Distribusi Sampel berdasarkan Lama Penyembuhan Luka Sirkumsisi.. 43

5.3 Analisis Perbedaan Lama Penyembuhan Luka Sirkumsisi berdasarkan IMT . 45

xiii

DAFTAR GAMBAR

Halaman

2.1 Pengaruh Obesitas terhadap Penyembuhan Luka .....................................22

2.2 Kurva Pertumbuhan CDC 2000 pada Laki-laki ........................................26

2.3 Kurva Pertumbuhan CDC 2000 pada Perempuan .....................................27

3.1 Kerangka Konseptual Penelitian ...............................................................32

4.1 Alur Penelitian ..........................................................................................40

5.1 Distribusi Lama Penyembuhan Luka Sirkumsisi berdasarkan IMT .........43

xiv

DAFTAR SINGKATAN

WHO : World Health Organization

SAW : Shallallahu ‘alaihi wasallam

HR : Hadis Riwayat

SWT : Subhanahu wa Ta’ala

IMT : Indeks Massa Tubuh

Riskesdas : Riset Kesehatan Dasar

Kg : Kilogram

M : Meter

Depkes : Departemen Kesehatan

RI : Republik Indonesia

CDC : Centers for Disease Control

BMI : Body Mass Index

IDAI : Ikatan Dokter Anak Indonesia

HPV : Human Papillomavirus

STD : Sexual Transmitted Disease

ATP : Adenosin Tri Phospat

BB : Berat Badan

HIF1α : Hypoxia-inducible factor 1 alpha

LOX : Lysil oxidase

NO : Nitric oxyde atau Nitrit Oksida

xv

DAFTAR LAMPIRAN

Halaman

1. Informed Consent Penelitian ....................................................................55

2. Kuesioner Pendampingan ........................................................................59

3. Checklist Komunikasi, Informasi, dan Edukasi .......................................60

4. Surat Keterangan Lolos Kaji Ilmiah Proposal Penelitian ........................61

5. Ethycal Clearance ....................................................................................62

6. Dokumentasi Penelitian ...........................................................................63

7. Tabulasi Progres Penyembuhan Luka Pasien Sirkumsisi ........................69

8. Hasil Analisis Data ..................................................................................77

9. Surat Keterangan Lolos Kaji Ilmiah Hasil Penelitian ..............................78

10. Lembar Konsultasi ...................................................................................79

11. Hasil Deteksi Plagiasi ..............................................................................80

51

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