Panduan Lengkap tentang Jahitan Matras Horizontal untuk Kerajinan dan DIY
Kamis, 04 April 2013
Sejarah Bedah Plastik
Kata plastik berasal dari bahasa yunani “Plasticos” yang artinya “to mold” atau “membentuk”. Jadi bedah plastik merupakan ranah disiplin kedokteran bedah yang memanfaatkan potensi sifat-sifat fleksibiitas jaringan (1) untuk tujuan memperbaiki kecacatan fisik dan fungsi anggota tubuh (rekonstruksi), (2) dan untuk tujuan menyempurnakan bentuk anggota tubuh yang secara fisik normal dan sehat menjadi lebih indah (estetik).
Selain itu di Persia, seorang dokter terkenal bernama Rhazes memperkenalkan pemakaian usus hewan untuk ligatures pada ±900M. Tetapi sebenarnya ha itu sudah pernah dipakai sebelumnya oleh bangsa Roma bernama Celcus, bukan dokter, yang berbicara tentang rekonstruksi di 8 buku tulisannya.
Karya-karya medis Sushruta dalam bahasa Sansekerta banyak diterjemahkan dalam bahasa Arab yang akhirnya menyebar ke Eropa melalui pedagang-pedagang Arab. Pada abad ke-15 di Eropa, seorang bangsa Italia bernama Tagliacozzi dari Bologna, memakai flab dari lengan untuk merekonstruksi hidung dan ditulis pada text book pertamanya “De Curtorum Chirurgia” pada tahun 1597. Dia disebut sebagai bapak bedah rekonstruksi modern. Tagliacozzi ditentang oleh greja dan dihukum karena dianggap mencampuri takdir Tuhan.
Pada tahun 1668 Van Meekren merekonstruksi defek tengkorak seorang tentara dengan tengkorak anjing. Tokoh bedah plastik yunani Von Graeve menulis Rhinoplastik pada tahun 1818. Dan Zeis menerbitkan “Handbuch der Plastichen Chirurgia” pada tahun 1838.
Dengan berkembangnya ilmu anestesi pada abad 19-20, maka berkembang pula ilmu bedah plastik, karena dapat melakukan operasi tanpa menimbulkan rasa sakit yang hebat.Ilmu bedah plastik masih terus berkembang sampai saat ini.
Prof. Dr. Djohansjah Marzoeki, dr., Sp.BP(K) adalah perintis yang membangun dan mengembangkan Bedah Plastik ini di Surabaya dan Indonesia. Pada tahun 1970 bedah plastik belum begitudikenal di Surabaya, belum ada sub spesialisnya, dan belum jelas bidang pelayanannya. Kasus bibir sumbing dilempar-lempar karena belum ada petunjuk yang jelas tentang teknik operasinya, operasi palatum angka kematiannya tinggi mencapai 50%, dan kasus luka bakar terbengkalai.
Corner Stitch
A variation of the horizontal mattress suture, the half-buried horizontal mattress suture, or corner stitch, is commonly used in closures performed in the office. 1 The corner stitch (Figure 4) is used to approximate angled skin flaps or corners without compromising blood supply to the tissue tip. 1 , 3 , 8 , 9 This suture technique avoids the tedious task of trying to place small sutures to hold both edges of a corner down without crossing any of the sutures near the tip. 3 , 5
The standard corner stitch is used for closure of tissue corners with an approximate 90-degree angle. Many variations of the corner stitch can be applied to close a variety of complex wounds, tissue with multiple corners, or skin flaps. Closure of Y-shaped or X-shaped wounds (Figure 5) is often accomplished with a corner stitch used for the central corners.
The corner suture is best initiated near an imaginary line that bisects the tissue opposite the tissue corner. This allows the pull of the tissue directly into the corner, and not off to one side. A plumb line drawn opposite the corner will help guide the start and finish of the corner stitch (Figure 6). The needle enters the skin next to the plumb line (1 to 2 mm from the line) about 6 to 8 mm from the corner. The needle passes to the wound edge about 4 to 6 mm from the corner. It enters into the wound at the depth of the deep dermis, not beneath the dermis.
The corner flap is elevated with Adson forceps (pick-ups), and the needle is passed from one edge of the flap to the opposite edge of the flap. The needle passes through the deepest portion of the flap dermis, about 4 mm from the corner tip. After passing through the corner, the needle can be placed backward in the needle holder. The needle then passes about 4 to 6 mm from the corner into the deep dermis of the opposite edge from where the needle previously passed. The needle exits the skin on the opposite side of the plumb line,6 to 8 mm from the corner. The suture is tied gently, allowing the tip to fit snugly into the corner. If the suture is tied too tightly, the corner tends to buckle.
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Ilmu Kedokteran Hewan sangat lah luas sehingga tidak lah cukup apabila hanya menimba ilmu dibangku perkuliahan saja. Oleh karena itu untuk menambah ilmu dan skill di lapangan kami memilih Balai Besar Pelatihan Peternakan (BBPP) Batu sebagai tempat pelatihan secara nyata. Kami memilih BBPP sebagai tempat kami menimba ilmu karena BBPP merupakan saah satu instansi yang yang bergerak aktif di bidang peternakan. Selain itu BBPP juga memelihara beberapa jenis hewan ternak yang dikembangkan untuk proses produksi dan pengolahan susu.
BALAI BESAR PELATIHAN PETERNAKAN, SONGGORITI, BATU Pembimbing Drh. Udik Sulijanto, Heru Nurwanto, Drh. Reni Indarwati Kegiatan dan Penanganan Kasus adalah sebagai Berikut :1. Sapi FH (pedet) lahir pada 18 – 10 – 2011 dengan gejala, hipersalivasi, Perut membesar (sedikit kembung), Nafas tersenggal-senggal,Lemas, Temp 37.5 ° C, Urine berdarah, Hidung mengering dan pecah2 (merupakan indikasi spesifik terhadap sapi yang menahan nyeri, panas dll). Terapi yang diberikan berupa pemberian vitamin B kompleks perinjeksi 5cc, antibiotik vetoxi LA/Vetodril perinjeksi 7cc, serta vitamin K perinjeksi 3 ampul.
2. Sapi FH teridentifikasi mengalami mastitis, terapi yang diberikan berupa Lactactox (ampisilin + Cloxacillin) : sejenis speed khusus untuk terapi mastitis digunakan sekali pakai serta antibiotik vetoksi LA
3. Peningkatan imunitas serta untuk meminimalisir tertularnya penyakit pada pedet sebanyak 5 ekor dengan pemberian vitamin B kompleks
Jahitan matras horizontal
Am Fam Physician. 2002,66(12):2231-2236
The interrupted vertical and horizontal mattress suture techniques are two of the most commonly used skin closure methods. These mattress sutures promote wound edge eversion and less prominent scarring. Vertical and horizontal mattress sutures allow for skin edges to be closed under tension when wound edges have to be brought together over a distance. The corner stitch, a variation of the horizontal mattress suture, is commonly used for closure of angled skin flaps or wounds. Although mattress sutures can produce surface scarring or “railroad marks,” early removal of these sutures can limit this damage.
The interrupted horizontal and vertical mattress suture techniques are two of the most commonly used skin closure methods. 1 – 3 These techniques provide many advantages, including the closure of wounds under tension when wound edges must be brought together over a distance. Mattress sutures are often performed as the anchoring stitch for skin flap closure. 1 Mattress suture techniques also promote skin edge eversion. 1 – 8 Because scars tend to retract over time, eversion of the wound edges at the time of closure promotes less prominent scarring. Eversion produced by the mattress sutures is valuable when closing sites with edges that tend to roll under, such as on the posterior neck or in the groin.
The techniques, indications, and pitfalls related to the standard mattress sutures are demonstrated in this article. One variation of the horizontal mattress suture, the half-buried horizontal mattress or corner stitch, is included because of its great usefulness in office closures. All of the suture techniques discussed in this article make use of nonabsorbable suture material. 1 , 4
Vertical Mattress Suture
The main indication for use of vertical mattress sutures is to evert the skin edges. 1 – 8 By incorporating a large amount of tissue within the passage of the suture loops, the technique permits greater closure strength and better distribution of wound tension. 1 , 3 The vertical mattress suture is commonly used in body sites where the wound edges tend to invert, such as the posterior neck or wounds that occur on a concave surface. Some authors believe that a properly placed vertical mattress suture everts wound edges better than any other suture technique. 5
The vertical mattress suture uses the far-far, near-near system (Figure 1). The far-far suture placement passes 4 to 8 mm from the wound edge, fairly deep in the wound below the dermis. 1 Prior undermining of the wound edges facilitates the placement of the sutures. Following the far-far passage of the needle across both sides of the wound, and before the suture is tied, the needle is placed backwards in the needle driver. The near-near placement occurs at a shallow depth (about 1 mm) and should be in the upper dermis. The near-near placement should be within 1 to 2 mm of the wound edge. Following the near-near passage of the needle, both ends of the suture thread should be tied on one side of the wound. These ends are tied so that the knot is on the side where the suture passage began.
The choice of suture material also influences scar formation, because materials with a large diameter (2-0 or 3-0 absorbable) produce greater skin injury than small-caliber (5-0 or 6-0) suture material. 1 Early removal of sutures can minimize the effect of cross-hatching, but care must be taken to prevent the wound from opening (wound dehiscence). Mattress sutures can be alternated with simple interrupted sutures, in this case, the mattress sutures can be removed first.
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