Manajemen Luka trauma /akut

Hairmyres A&E

Tipe luka Tidak semua luka laserasi

Luka Laserasi Vs luka IncisiHairmyres A&E

Hairmyres A&E

Hairmyres A&E

Hairmyres A&E

Tipe luka Hubungan dengan penyebab GesekanAbrasiFlapBenda tajamLuka insisi Luka stab Benda tumpul Blunt ObjectLacerationBurst woundHairmyres A&E

Hairmyres A&E

Lacerasioleh blunt trauma

Luka robek dan terbuka

irregular

Lapisan luka kontusio

Perdarahan

Hairmyres A&E

Hairmyres A&E

Hairmyres A&E

Hairmyres A&E

Luka incisi Oleh benda tajam

Clean, straight edge

Bleeds profusely

Less tissue damage

Hairmyres A&E

Hairmyres A&E

Hairmyres A&E

Hairmyres A&E

Hairmyres A&E

Hairmyres A&E

Tipe lain Gigitan

Stab wound

AbrasiHairmyres A&E

Hairmyres A&E

Penanganan Angkat benda asing dan bekuan darah

Cukur bila perlu

Anastesi lokal mungkin perlu

Hairmyres A&E

Hairmyres A&E

Cek dan catat fungsi neurovaskular bagian distal Selalu X-Ray bila gelas/kaca Tanyakan status tetanus Hairmyres A&E

Hairmyres A&E

Risiko infeksi Luka dalam Lapisan luka rusak/kontusio Jaringan mengalami Macam kontaminasi Bersih Kontaminasi Kotor Gigitan Suplai darah yang buruk Faktor pasien Hairmyres A&E

Hairmyres A&E

Tujuan penanganan Haemostasis

Penutupan

Angkat benda asing dan kontaminasi

Minimal skar

Cepat kembalikan normal aktivitas Hairmyres A&E

Hairmyres A&E

Penutupan Primary Closure

Delayed primary closure

Healing by secondary intentionHairmyres A&E

Hairmyres A&E

Gigitan Jangan dijahit kecuali mukaKucing ; Pasturella AnjingUlar Ll Hairmyres A&E

Hairmyres A&E

terlambat Jangan dijahit luka lebih dari 6 jam

Bersih dan dressing

Review 48 72 jam

Kemungkinan delayed primary closure

Hairmyres A&E

Hairmyres A&E

Tahap penutupan luka Inspeksi Persiapan AnesthesiaIrigasiHairmyres A&EExplorasiDebridemenPenutupan Dressing

Hairmyres A&E

Pemeriksaan fisik Deskripsi luka Location, length, widthNeurovascular check Hairmyres A&E

Hairmyres A&E

Persiapan Mengurangi infeksi Positioning patientUniversal precautionsGloves, gown, gogglesPembersihan kulit Povidine-iodine (betadine), antispetik lain yang sesaui Polaxamer-188 (Sur Clens)Hairmyres A&E

Hairmyres A&E

Anastesi TopicalLocalNerve blocksIV sedationHairmyres A&E

Hairmyres A&E

Hairmyres A&ETeknik jahitan Simple interrupted

Continuous (running)

Vertical Mattress

Horizontal Mattress

Hairmyres A&E

Hairmyres A&E

Hairmyres A&E

Hairmyres A&E

Hairmyres A&E

Benang ABSORBABLE SYNTHETICVicrylDexonPDSMaxon

NATURALCatgut (plain or chromic)Hairmyres A&E

Hairmyres A&E

NON-ABSORBABLE SUTURESSYNTHETICNylonProleneGortexNATURALSilkLinenCottonHairmyres A&EAbsorbablePlain gutChromic gutMonocrylVicrylNon-absorbableSilkNylonProlenePolyester/dacron

Hairmyres A&E

Mengangkat jahitan Hairmyres A&E

FACE3-5 daysHEAD & NECK5 7 daysLeg/foot 8-14 days Arm /hand10 daysFINGERSScalp 5 days7-10 days

Hairmyres A&E