Faktor-Faktor yang Berhubungan dengan Kejadian Wound Dehiscence pada Pasien Post Laparatomi

Abstract

Wound dehiscence sering terjadi setelah pembedahan mayor abdomen menimbulkan tingkat morbiditas dan mortalitas yang tinggi. Wound dehiscence dapat menimbulkan stress, eviserasi, reoperasi, gangguan citra tubuh, meningkatnya lama rawat dan biaya rawat, menurunkan kualitas hidup pasien serta kematian sehingga perlu menangani faktor yang mempengaruhi kejadian wound dehiscence. Tujuan dari penelitian ini adalah untuk menganalisis faktor-faktor yang berhubungan dengan kejadian wound dehiscence pada pasien dewasa post laparatomi di RSUP Dr Hasan Sadikin Bandung. Metode penelitian menggunakan analitik korelasi dengan pendekatan cross sectional. Sampel yang digunakan berjumlah 40 orang yang diambil dengan menggunakan consecutive sampling. Pengumpulan data dengan cara wawancara, observasi dan studi dokumentasi. Analisis univariat menggunakan distribusi frekuensi dan analisis bivariat menggunakan uji Chi Square. Hasil penelitian menunjukkan kejadian wound dehiscence terjadi ketika perawatan di rumah (35%). Hasil analisis bivariat menunjukkan adanya hubungan yang signifikan antara infeksi luka (p=0,0001), operasi emergensi (p = 0,020), hipoalbumin (p=0,037), anemia (p = 0,028), status nutrisi (0,010), dan adanya penyakit penyerta (p = 0,008) dengan kejadian wound dehiscence, serta tidak ada hubungan yang signifikan antara faktor usia (p = 0,581) dan jenis kelamin (p= 0,604) dengan kejadian wound dehiscence. Penting bagi perawat untuk mengidentifikasi potensial faktor risiko wound dehiscence pada pasien yang dilakukan operasi laparatomi dan segera melakukan intervensi yang diperlukan untuk mencegah terjadinya komplikasi wound dehiscence, diantaranya dengan melakukan discharge planning terkait perawatan luka dan pentingnya asupan protein yang adekuat supaya bisa dikenali ditahab mana terjadinya wound dehiscence. Kata kunci: Pasien, post laparatomi, wound dehiscence. Factors correlating of Wound Dehiscence in Patients after Laparatomi at Dr Hasan Sadikin General Hospital Bandung Absract Wound dehiscence is often occurred after major abdominal surgery which impacts on morbidity and mortality rates and significantly contributes to prolonged hospital stays, implicit and explicit costs, associate with psychosocial stressor on patients, evisceration re-surgical operation, and may affect to quality of life patients. It is therefore necessary to identify factors affecting wound dehiscence. The aims of the study was to analyze factors correlating of post-operative wound dehiscence in adult patients at Dr Hasan Sadikin general hospital. Correlational analytic with cross sectional approach was used in this study. 40 patients were selected to be participated in this study by using consecutive sampling. Observations, interviews and study documents were conducted in data collection process. Univariate and Bivariate analysis with Chi Square were performed to analyze the data. Results of the study identified than wound dehiscence were occurred during patients at home (35%). Result of analysis bivariate showed that there was a significance correlation between wound infection (p=0, 0001), surgical emergency (p = 0,020), hypo albumin (p=0,037), anemia (p = 0,028), nutrition status (0,010), and other illness (p = 0,008) with wound dehiscence. Whereas, there was no correlation significantly between age factor (p = 0,581) and gender (p= 0,604) with wound dehiscence. It is important for nurses to identify potential risk factors of wound dehiscence in patients after post-operative laparotomy and prevent complication of wound dehiscence by doing discharge planning especially in term of wound care and the need of taking protein consumption adequately to avoid wound dehiscence. Key words: Adult patients, post-laparatomi, wound dehiscence.