Analisis Intervensi Keperawatan dengan Penggunaan Aquacel Ag dan Zinc Cream pada Fase Proliferasi Ulkus Dekubitus pada Pasien Tn.K Dan Tn.M dengan Diagnosa Ca Paru di Rs Siloam Semanggi Jakarta Selatan

Hilda Mariyana* -  Fakultas Ilmu Kesehatan, Program Studi Keperawatan, Universitas Nasional, Jakarta, Indonesia
Naziyah Naziyah -  Fakultas Ilmu Kesehatan, Program Studi Keperawatan, Universitas Nasional, Jakarta, Indonesia
DOI : 10.33024/jkpm.v6i3.8682
ABSTRAK 

Kejadian Decubitus Ulcer (luka tekan) diseluruh dunia berkisar 1% - 56%. Selanjutnya, dilaporkan juga dari prevalensi luka tekan yang terjadi dari Negara dan benua lain yaitu 49% di Eropa, 22% di Amerika Utara, 50% di Australia. Sedangkan prevalensi kejadian dekubitus pada pasien Cancer. Di Korea khususnya di kejadian luka tekan meningkat dari 10,5% - 45%. Di Indonesia, kejadian luka tekan pada pasien yang dirawat mencapai 33%. Angka ini sangat tinggi bila dibandingkan dengan angka luka tekan di Asia Tenggara yang berkisar 2,1% - 31,3%. Tekanan yang berkepanjangan merupakan penyebab utama luka tekan karena tekanan dapat menyebabkan insufisiensi aliran darah, anoreksia, dan iskemia jaringan lunak. Perawatan granulasi di fase proliferasi bisa menggunakan Aquacel Ag ditambah Zinc Cream. Aquacel Ag dapat mengganggu dan menghancurkan biofilm luka yang dapat membantu luka yang sulit sembuh untuk berkembang dan menciptakan antarmuka penyembuhan luka yang lembab (Metcalf et al, 2017) Dan Zinc Cream untuk area tepi dibalut dengan transparant dressing supaya luka tidak tergesek,terkena cairan/benda asing lainnya supaya tetap aman. Menganalisis efektivitas autolitik debridement dengan intervensi penggunaan aquacel ag dan metcovazin cream pada jaringan granulasi ulkus dekubitus pada klien dengan diagnosa medis ca paru di mrccc siloam semanggi jakarta selatan. Aquacel ag dan zinc cream digunakan pada Tn K 4 kali dan Tn M 4 kali dan dengan frekuensi perawatan 1 hari 1 kali. Perubahan luka dapat dilihat setelah penggunaan aquacel ag dan zinc cream masing-masing pada klien yaitu Tn K dengan ukuran luka di bokong kanan 11 x 8 cm, Luka di bokong kiri 8 x 5,5 cm menjadi luka decubitus putih keabu-abuan/hypopigmentasi jaringan maturasi, tampak luka di tengah atas dengan  ukuran 3x3.5cm disertai nekrotik di bagian tengan dengan ukuran 1x1 cm dan Tn M dengan luka ukuran 15x10cm menjadi 14x9cm. Penggunaan aquacel ag dan metcovazin cream pada Tn M ada nyeri seperti rasa perih tertusuk. Nyeri dapat dicegah dengan melindungi kulit sekitar luka dengan diberi zinc cream lalu ditutup Therasorb (foam) dan transparant dressing. Therasorb sebagai salah satu alternatif yang memiliki fungsi offloading yang melindungi luka dari tekanan berlebihan,menciptakan lingkungan yang moist/lembab dan kondusif untuk penyembuhan luka. Penggunaan aquacel ag dan metcovazin cream pada jaringan granulasi sangat efektif mempersingkat waktu dalam penyembuhan luka dan mempercepat pembentukan epitelisasi ditandai dengan perubahan ukuran luka yang signifikan dan keadaan kulit yang cepat membaik.

 

Kata Kunci: Ulkus Dekubitus, Aquacel Ag & Zinc Cream, Proliferasi

ABSTRACT

 

The incidence of Decubitus Ulcers (pressure sores) worldwide ranges from 1% - 56%. Furthermore, it is also reported from the prevalence of pressure sores that occur from other countries and continents, namely 49% in Europe, 22% in North America, 50% in Australia. While the prevalence of pressure sores in Cancer patients. In Korea, especially in the incidence of pressure sores increased from 10.5% - 45%. In Indonesia, the incidence of pressure sores in treated patients reaches 33%. This figure is very high when compared to the pressure ulcer rate in Southeast Asia which ranges from 2.1% - 31.3%. Prolonged pressure is a major cause of pressure sores because pressure can lead to insufficiency of blood flow, anorexia, and soft tissue ischemia. Granulation treatment in the proliferative phase can use Aquacel Ag plus Zinc Cream. Aquacel Ag can disrupt and destroy wound biofilms which can help poorly healed wounds to develop and create a moist wound healing interface (Metcalf et al, 2017) other foreigners to stay safe. Analyzing the effectiveness of autolytic debridement with the intervention of using Aquacel Ag and metcovazin cream on granulation tissue of decubitus ulcers in clients with a medical diagnosis of lung cancer at MRCCC Siloam Semanggi, South Jakarta Aquacel ag and zinc cream were used on Mr K 4 times and Mr M 4 times and with a treatment frequency of once every 1 day 1 time. Changes in the wound can be seen after using aquacel ag and zinc cream on each client, namely Mr. K with a wound on the right buttocks 11 x 8 cm, Wound on the left buttocks 8 x 5.5 cm to a grayish white decubitus wound / tissue hypopigmentation maturation, visible wound in the upper middle with a size of 3x3.5cm with necrotic in the middle with a size of 1x1 cm and Mr. M with a wound size of 15x10cm to 14x9cm. The use of aquacel ag and metcovazin cream on Mr. M has pain like a stabbing pain. Pain can be prevented by protecting the skin around the wound with zinc cream and then covered with Therasorb (foam) and transparent dressing. Therasorb as an alternative that has an offloading function that protects the wound from excessive pressure, creates a moist environment and is conducive to wound healing. The use of aquacel ag and metcovazin cream on granulation tissue is very effective in shortening the time in wound healing and accelerating the formation of epithelialization characterized by significant changes in wound size and rapidly improving skin conditions.

 

Keyword:  Decubitus Ulcer, Aquacel Ag & Zinc Cream, Proliferasi

Kata Kunci : Ulkus dekubitus, aquacel ag & zinc cream, proliferasi

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