Factors that Affecting the Skin Necrotic due to Extravasation Injury and Modality Theraphy at Pediatric Inpatient Ward dr. Soetomo Hospital Surabaya (Januari - Desember 2019)

Abstract

Background: Extravasation injury is the most common complication of intravenous therapy in children. Research in the NICU at UK, found extravasation injury caused skin necrotic 38/1000 neonates, 70% of preterm neonates. Extravasation injuries and their sequels can be more serious morbidity than the underlying disease, potentially for amputation. The research objective was to determine the factors that influence the incidence of skin necrotic due to extravasation injury and the types of treatment modalities in the pediatric hospital Dr. Soetomo Hospital Surabaya for the period January - September 2019.Methods: This research is descriptive analytic with cross sectional approach with collected data from medical records. The medical records of 44 pediatric patients undergoing treatment at the pediatric inpatient ward of Dr. Soetomo Hospital Surabaya with skin necrotic due to extravasation injury which was brought to the Reconstructive and Aesthetic Plastic Surgery Dr. Soetomo Hospital Surabaya for the January - December 2019 period was reviewed retrospectively. We analyzed patient characteristics, risk factors, types of wound care therapy modalities, and case outcomes.Results: There were 44 cases of skin necrotic injury due to extravasation injury, with the largest percentage of neonates group (34%), male gender (66%), hypertonic fluids / drugs (73%), most regions of dorsum and wrist dextra (17%) and the most used therapeutic modality was autolytic debridement (45%).Conclusions: From this study, several conclusions can be drawn regarding the prevalence of skin necrotic due to extravasation injury, there was a relationship between the incidence of skin necrotic injury due to extravasation injury with age, types of fluid/drug given, and the location of the peripheral venous line, whereas the incidence was not related to gender. The initial treatment modality that is still frequently used today is autolytic debridement.

Efectiveness of Using a Combination of Hydrogel and Hydrocellular Foam in the Process of Autolytic Debridement in Healing Diabetic Ulcers

“…Active debridement meliputi berbagai metode seperti: debridement bedah, debridement mekanis, debridement enzimatik, dan debridement biologis yang secara aktif menghilangkan jaringan nekrotik atau mati pada area luka. Sementara itu, autolytic debridement adalah proses alami tubuh yang secara bertahap memecah jaringan nekrotik pada area luka dengan mengandalkan enzim proteolitik yang dilepaskan oleh tubuh sebagai respons terhadap luka atau cedera (Saputro et al, 2021). Ketika terjadi luka atau cedera, tubuh secara alami melepaskan enzim proteolitik dengan beberapa tujuan, antara lain menguraikan dan menghilangkan jaringan mati, mengendalikan peradangan atau infeksi, mengurangi kelembaban berlebih, serta menstimulasi pertumbuhan jaringan baru di sekitar luka (Carlos, 2021).…”