Background and Objectives: Between 2007 and 2011, the mortality rate for burns patients at Dr. Soetomo General Hospi- tal, Surabaya, Indonesia was 14.1% and 60% were suspected to be sepsis-related. Immunosuppression, gut barrier disruption, and intestinal hypomotility cause bacterial and bacterial product translocation. Probiotics improve the intestinal microbiome and eventually reduce bacterial translocation, and an increased secretory immunoglobulin A (SIgA) secretion post-adminis- tration of a multi-species probiotic has been observed. We aimed to determine whether a single-strain probiotic administra- tion could show strengthened intestinal immunity, through an increase in SIgA levels, as with multi-strain probiotics. Materials and Methods: Sixteen burns patients from our hospital Burns Centre were randomized into three treatment groups, and the patients were administered either a placebo, a Lactobacillus reuteri protectis probiotic, or a Bifidobacterium infantis 35624 probiotic for 14 consecutive days. The SIgA levels were analyzed using ELISA pre- and post-treatment. Results: The post-treatment SIgA levels in the placebo, Lactobacillus reuteri protectis probiotic, and Bifidobacterium infantis 35624 probiotic groups were 222.56±74.22 mg/dL, 223.92±68.89 mg/dL, and 332.38±64.27 mg/dL, respectively. Decreased SIgA levels were observed in the placebo (7.19±15.87) and in the Lactobacillus reuteri protectis probiotic (1.9920±14.76) groups, whereas an increase was seen in the SIgA level in the Bifidobacterium infantis 35624 probiotic group (58.26±77.41). Conclusion: The Bifidobacterium infantis 35624 single-strain probiotic is generally superior to Lactobacillus reuteri protec- tis in altering intestinal immunity; however, this finding was not statistically significant. A multi-strain probiotic supplement is recommended for burns patients.
Latar Belakang: Luka bakar adalah cedera pada kulit atau jaringan organik lainnya yang disebabkan oleh panas, radiasi, zat radioaktif, listrik, gesekan atau kontak dengan bahan kimia. Cedera pada saluran pernapasan akibat inhalasi asap, juga dianggap sebagai luka bakar (WHO, 2018). Bagian tubuh yang mengalami luka bakar akan vasodilatasi akibat adanya stimulus mediator inflamasi yang dilepaskan oleh sel endotel, platelet dan leukosit yang rusak, mengakibatkan peningkatan tekanan hidrostatik kapiler yang menyebabkan meningkatnya permeabilitas membran kapiler. Keadaan ini membuat cairan dan elektrolit di intravaskuler keluar ke ekstravaskuler. Albumin juga ikut keluar ke ekstraseluler pada proses ini, sehingga terjadi hipoalbuminemia. Hipoalbuminemia adalah kondisi dimana kadar albumin dalam darah berada dibawah 3,5 g/dl, sedangkan kadar normal albumin normal dalam darah adalah 3,8-5,0 g/dl. Berdasarkan Formularium Nasional sesuai Kepmenkes 2017 perihal pembatasan pemberian albumin infus yang didukung oleh JKN-KIS, ditetapkan bahwa pasien luka bakar diberikan transfusi human albumin bila kadar albumin kurang 2,5 g/dl. Diperlukan adanya solusi untuk peningkatan kadar albumin selain melalui transfusi, dengan syarat alternatif transfusi albumin ini diharapkan lebih hemat dan efisien dibandingkan dengan albumin transfusi yang terkenal mahal. Ekstrak Channa striata merupakan sebuah produk baru yang diharapkan dapat menjadi alternatif albumin transfusi ini. Tujuan: Tujuan penelitian adalah untuk mengetahui apakah pemberian kapsul ekstrak Channa striata dapat meningkatkan kadar albumin dalam darah pada kasus luka bakar. Metode: Metode penelitian ini menggunakan metode systematical review dengan mengambil jurnal melalui Google Scholer, PubMed dan ScienceDirect. Kesimpulan: Kesimpulan dari penelitian ini adalah kapsul ekstrak Channa striata dapat meningkatkan kadar albumin dalam tubuh serta mempercepat penyembuhan luka pasien luka bakar. Kapsul ekstrak Channa striata biasanya diberikan sebagai suplementasi bersama bahan lain untuk memenuhi kebutuhan gizi pasien. Penelitian yang saya temukan selain membuktikan efek kapsul ekstrak Channa striata terhadap kadar albumin juga memberikan hasil lain mengenai pemberian ekstrak Channa striata pada luka bakar yaitu penurunan kadar MDA serum dan meningkatkan balans nitrogen ke arah positif.
Background: A wound is a discontinuity of any bodily tissue due to various causes. Every wound of any severity could result in problems related to its healing process, such as scar tissue formation. According to the duration of its healing process, wound is divided into 2 categories: acute wound that takes approximately 3-4 weeks to heal and chronic wound that needs 4-6 weeks and resulted from inappropriate healing of the acute wound. Tretinoin's use in wound healing has been controversial for more than 40 years. Topical Tretinoin has keratolytic effect that stimulates fibroplasia and epithelization on full-thickness wounds. On the other hand, single administration along with long-contact topical Tretinoin has an irritative effect that could delay healing due to continuous inflammation. This study aims to explore the effectiveness of single administration compared to repeated administration of topical Tretinoin in full-thickness acute wound healing on rats at Faculty of Veterinary Medicine, Airlangga University, Surabaya. Methods: This experimental study involved 27 male rats which were randomly divided into 3 groups: control (A), single-administration (B), and repeated-administration (C). Full-thickness wound size 20 mm in diameter was made on the skin of each rat. On group A, wounds were covered with Tulle and transparent dressing. On group B, wounds were treated with lidocaine 2% and tretinoin solution 0,05% in single administration, while the same treatment was given repeatedly on group C for 4 days straight. Evaluation was done microscopically on day 5 according to epithelization phase on wound healing with hematoxylin and eosin (H&E) staining. Results: The result from the calculation showed that group C obtained a significantly higher average number of fibroblast cells count compared to the treatment group A and B. The average number of fibroblast cells in treatment group B was three times higher than the number of fibroblast cells in treatment group A, while the average number of fibroblast cells in treatment group C was three times the number of fibroblast cells in treatment group B. From the statistic, it was proven that the regular application of 0.05% topical tretinoin solution in a full-thickness wound (Group C) has shown a significant increase in the number of fibroblasts during the proliferative phase. Conclusion: A frequent administration of 0.05% topical tretinoin solution resulted in a higher number of fibroplasia improvements compared to once administered in full thickness acute wound healing, however it did not result in epithelialization on day 5.
The rate of failed skin graft in Dr. Soetomo General Academic Hospital Surabaya was around 26% of the cases, and it became a concern because skin graft was the main procedure to close large burn wounds. Many problems might affect this event; one of them was electrolyte imbalance. Hypernatremia was found in major burn patients. This condition disrupted the wound healing process of skin graft. This cross-sectional study evaluated patients with burns admitted to the Burn Centre of Dr. Soetomo Hospital between January 2014 and December 2018. 143 subjects participated in this study. Hypernatremia was found in 16% of all subjects (23 subjects), 19% with hypernatremia (28 subjects), and the majority of it, 65% with normonatremia (92 subjects). This study found that the risk of failed skin graft was higher on hypernatremia than normonatremia subjects. This risk was higher if the skin graft procedure took more than 10%.
Background and Objectives: Between 2007 and 2011, the mortality rate for burns patients at Dr. Soetomo General Hospital, Surabaya, Indonesia was 14.1% and 60% were suspected to be sepsis-related. Immunosuppression, gut barrier disruption, and intestinal hypomotility cause bacterial and bacterial product translocation. Probiotics improve the intestinal microbiome and eventually reduce bacterial translocation, and an increased secretory immunoglobulin A (SIgA) secretion post-administration of a multi-species probiotic has been observed. We aimed to determine whether a singlestrain probiotic administration could show strengthened intestinal immunity, through an increase in SIgA levels, as with multi-strain probiotics. Materials and Methods: Sixteen burns patients from our hospital Burns Centre were randomized into three treatment groups, and the patients were administered either a placebo, a Lactobacillus reuteri protectis probiotic, or a Bifidobacterium infantis 35624 probiotic for 14 consecutive days. The SIgA levels were analyzed using ELISA pre- and post-treatment. Results: The post-treatment SIgAlevelsin the placebo, Lactobacillusreuteri protectis probiotic, and Bifidobacterium infantis 35624 probiotic groups were 222.56±74.22 mg/dL, 223.92±68.89 mg/dL, and 332.38±64.27 mg/dL, respectively. Decreased SIgA levels were observed in the placebo (7.19±15.87) and in the Lactobacillus reuteri protectis probiotic (1.9920±14.76) groups, whereas an increase was seen in the SIgA level in the Bifidobacterium infantis 35624 probiotic group (58.26±77.41). Conclusion: The Bifidobacterium infantis 35624 single-strain probiotic is generally superior to Lactobacillus reuteri protectis in altering intestinal immunity; however, this finding was not statistically significant. A multi-strain probiotic supplement is recommended for burns patients.
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