Negative Pressure Wound Therapy (NPWT) sebagai Manajemen Surgical Site Infection (SSI) Pada Pembedahan Fusi Spinal: Studi Literatur
DOI:
https://doi.org/10.32583/keperawatan.v15i4.1186Keywords:
infeksi luka operasi, negative pressure wound therapy, operasi fusi spinalAbstract
Surgical Site Infection (SSI) atau infeksi luka operasi pada prosedur pembedahan fusi spinal diketahui dapat meningkatkan mortalitas, biaya perawatan dan intervensi medik berulang. Negative Pressure Wound Therapy (NPWT) atau terapi perawatan luka dengan sistem tekanan negatif secara umum telah menunjukkan hasil yang menjanjikan dalam manajemen SSI dan percepatan pemulihan luka operasi pada berbagai prosedur pembedahan. Namun, kajian tentang penggunaan NPWT pada prosedur pembedahan fusi spinal masih terbatas. Telaah literatur ini bertujuan untuk mengevaluasi efektifitas NPWT dalam manajemen SSI spesifik pada prosedur pembedahan fusi spinal baik sebagai profilaksis maupun perawatan setelah terjadi insiden SSI. Metode telaah literatur dilakukan dengan pencarian artikel penelitian yang membandingkan penggunaan NPWT dan Standard Wound Dressing (SWD) dengan desain penelitian kohort atau Randomized controlled trials (RCT) yang relevan menggunakan online database Embase, Scopus, PubMed, dan ScienceDirect. Mekanisme kerja dan cara pengaplikasian NPWT untuk manajemen luka insisi pasca pembedahan fusi spinal juga turut dijelaskan. Artikel penelitian dibatasi dari tahun 2017-2022. Diperoleh enam artikel yang memenuhi kriteria inklusi dengan tiga artikel sebagai manajemen profilaksis dan tiga artikel lainnya sebagai manajemen perawatan setelah terjadi insiden SSI. Hasil analisis menunjukkan bahwa penggunaan NPWT sebagai profilaksis efektif menurunkan insiden SSI, sementara NPWT sebagai manajemen perawatan dapat menurunkan durasi perawatan luka dengan risiko tertinggalnya fragmen material balutan pada luka yang lebih rendah dan jumlah prosedur yang lebih sedikit untuk mencapai penutupan luka operasi fusi spinal. Evidence based yang telah ada saat ini merekomendasikan penerapan NPWT untuk manajemen SSI pasca operasi fusi spinal. Sehubungan dengan masih kurangnya bukti klinis yang kuat tentang efikasi dari penerapan NPWT ini, maka masih diperlukan penelitian Randomized Prospective Clinical Trials lanjutan.
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