gado-gado bedah umum
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LUKA
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DEFINISI
HILANG ATAU RUSAKNYA SEBAGIAN JARINGANTUBUH
VULNUS SCISSUMLUKA SAYAT
VULNUS PUNCTUMLUKA TUSUK
VULNUS LACERATUMLUKA ROBEK
TEPI TIDAK RATA, ADA JEMBATAN JARINGAN
VULNUS EKSKORIASILUKA LECET
AKIBAT GESEKAN
VULNUS SKLOPETERUMLUKA TEMBAK
VULNUS MORSUMLUKA GIGIT
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FASE PENYEMBUHAN LUKA
FASE INFLAMASI SEJAK TERJADINYA LUKAHARI KE 5
PEMBULUH DARAH PUTUSVASOKONSTRIKSI, RETRAKSI,HEMOSTASIS, KOAGULASIREAKSI INFLAMASI MAKIN
JELAS, growth factor, leukosit turut berperan FASE PROLIFERASI (FASE FIBROPLASIA)
HARI 6 (AKHIR INFLAMASI)HARI 21
ATAU SAMPAI EPITEL SALING MENYENTUH DAN MENUTUPSELURUH PERMUKAAN LUKA
FASE REMODELLING BERBULAN-BULAN/ ATAU SAMPAI SEMUA TANDA RADANG
SUDAH LENYAP
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CARA PENYEMBUHAN LUKA
1) PRIMER LUKA BERSIHTIDAK TERINFEKSIDIBANTU DENGAN
JAHITAN
2) SEKUNDER
LUKA DIBIARKAN TERBUKA
TERISI JARINGAN GRANULASI,DARI TEPI EPITEL TUMBUHGRANULASI TERTUTUP EPITEL(EPITELISASI)
BIASANYA LAMA
3) TERSIER
LUKA COMPANG-CAMPING; LUKA YANG TERINFEKSI BERAT;LUKA YANG TIDAK BERBATAS TEGAS
LUKA DIBERSIHKAN DAN DI EKSISI ( DEBRIDEMANT)DIBIARKAN SELAMA 4-7 HARIDIJAHIT (DIUPAYAKAN UNTUKSEMBUH PRIMER)
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TRAUMA THERMAL(LUKA BAKAR/ COMBUSTIO)
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BURNS TRAUMA
Significant burns are associated with
massive release of inflammatory mediators, both in the wound and inother tissues ( Fig. 22-5 ).
These mediators produce vasoconstriction and vasodilation
increased capillary permeability and edema locally and in distant organs
The generalized edema occurs in response to changes in Starling forces in bothburned and unburned skin
Initially, interstitial hydrostatic pressure decreases dramatically in the burnedskin, and there is an associated slight increase in interstitial pressure in thenonburned skin
As plasma oncotic pressure decreases and interstitial oncotic pressureincreases as a result of the protein loss induced by increased capillarypermeability, edema forms in the burned and nonburned tissues. Theedema is greater in the burned tissues because of lower interstitialpressure.
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DERAJAT KEDALAMAN LUKA BAKARsabiston 18thed
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THE RULES OF NINES (WALLACE)
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RUMUS RESUSITASI CAIRAN
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RUMUS RESUSITASI CAIRAN LUKA BAKAR
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CLAVUS
MEDSCAPE
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Clavus
Callosity; Hyperkeratotic response to trauma;corn; heloma; heloma durum; heloma molle
A thickening of the skin due to intermittent
pressure and frictional forces (Chronic orrepetitive motion may also induce clavusformation)hyperkeratosischronic pain
Seems like hyperkeratotic or thickened skin Maceration and secondary fungal or bacterial
infections common overlying
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Clavus
DD/ Acanthosis Nigricans;
Acrokeratoelastoidosis; Arsenical Keratosis;
Atypical Fibroxanthoma; Atypical Mole
(Dysplastic Nevus); Nevi, Melanocytic Warts,Nongenital; Warty Dyskeratoma
AWARE for the presence of neuritis, diabetes
mellitus and other condition
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http://emedicine.medscape.com/article/1060224-overviewhttp://emedicine.medscape.com/article/1060224-overview -
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Clavus
Goal Therapy : reducing symptoms such as
pain and discomfort with walking
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LIPOMA
A lipoma is a soft, fatty lump that grows under the skin. It is harmless andcan usually be left alone.(NHS Choices)
Histologic examination reveals a lobulated tumor composed of normal fatcells. (Schwartz)
Th/ EXTIRPATIONComplete removal or eradication of an organ tissue
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