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Journal : JBN (Jurnal Bedah Nasional)

Comparison of Mortality and Glasgow Outcome Scale Extended (GOSE) between Craniotomy and Decompressive Craniectomy in Patients with Traumatic Acute Subdural Hematoma at Sanglah General Hospital, Bali Ni Luh Putu Julita Yanti; I Wayan Niryana; Sri Maliawan; I Nyoman Semadi; Tjokorda G. B. Mahadewa; I G. A. B. Krisna Wibawa
JBN (Jurnal Bedah Nasional) Vol 6 No 1 (2022): JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/JBN.2022.v06.i01.p03

Abstract

Background: Craniotomy and decompressive craniectomy and are surgical modalities for the evacuation of acute subdural hematoma (SDH). These two techniques show different outcomes in various existing studies. The superiority between either techniques remains controversial. Objective: To determine the outcome comparison of mortality and Glasgow Outcome Scale Extended (GOSE) craniotomy with decompressive craniectomy in patients with traumatic acute SDH. Methods: This is a historical cohort study. Samples of the study were collected from January 2018 to March 2020 at Sanglah General Hospital. All patients with acute traumatic SDH who underwent SDH evacuation with craniotomy and decompressive craniectomy were assessed for mortality status at discharge and GOSE 3 months after surgery. Independent T-test will be carried out if the numerical variable were all normally distributed, while Mann-Whitney U test will be performed if otherwise. A Chi-square test will be performed on all unpaired categorical variables. Statistical analysis was performed with SPSS 25 with 95% confidence intervals. Results: As many as 40 subjects with traumatic acute SDH who underwent craniotomy and 40 subjects with traumatic acute SDH who underwent decompressive craniectomy were included in this study. There was no significant difference in mortality (RR: 1; 95% CI 0.67-1.87; p=0.651) and GOSE score (p=0.718) in traumatic acute SDH who underwent craniotomy or decompressive craniectomy. Conclusion: There was no difference in mortality and GOSE outcomes between a craniotomy and decompressive craniectomy for management of traumatic acute SDH.
Perbandingan Jumlah Sel Mononuklear, Jumlah Sel Fibroblas, Ukuran Fibrosis, dan Perlengketan Klinis Pada Jaringan Peridural Antara Non-Absorbable Mesh dan Absorbable Barrier Mesh Pada Tikus Wistar dengan Cedera Otak Traumatika yang Dilakukan Decompressive Craniectomy Ida Bagus Yudha Prasista; I Wayan Niryana; Nyoman Golden
JBN (Jurnal Bedah Nasional) Vol 4 No 1 (2020): JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (258.971 KB) | DOI: 10.24843/JBN.2020.v04.i01.p03

Abstract

Tujuan: Penelitian ini bertujuan untuk membandingkan dua jenis mesh yaitu non-absorbable mesh dan absorbable barrier mesh terhadap sel mononuklear, fibroblas, ketebalan fibrosis dan perlengketan klinis pada jaringan peridural tikus wistar dengan traumatic brain injury. Metode: Studi ini menggunakan model hewan coba dengan desain Randomized post Test-Only Control Group. Penelitian melibatkan dua puluh sampel. Sebanyak sepuluh sampel yang menggunakan non-absorbable mesh masuk dalam kelompok kontrol dan sepuluh sampel yang menggunakan absorbable barrier mesh masuk dalam kelompok perlakuan. Untuk pemeriksaan jumlah sel mononuklear (MN), jumlah sel fibroblas dan ukuran fibrosis, serta perlengketan klinis pemeriksaan dilakukan di laboratorium setelah sebelumnya dilakukan euthanasia setelah hari ke-14. Uji T independen dan uji Mann Whitney dilakukan untuk menguji hipotesa dengan skala data numerik serta uji Fisher’s exact untuk menguji hipotesa dengan skala data kategorik. Hasil: Rerata jumlah sel mononuklear (MN) per lapang pandang (LP) pada kelompok dengan perlakuan lebih rendah daripada kelompok kontrol (10,6±5,6 vs 13,8±5,6 per LP). Jumlah rerata sel fibroblas per LP pada kelompok perlakuan lebih rendah dibandingkan dengan kontrol (13,6±4,3 vs 20,2 ±7,3 per LP). ketebalan ukuran fibrosis juga menunjukkan perbedaan rerata yang signifikan lebih rendah pada kelompok perlakuan (183,4 ± 87,7 vs 458,5±247,1). Resiko relative terjadinya perlengketan klinis pada non-absorbable mesh juga 3 kali lebih besar dibadingkan dengan absorbable barrier mesh. Simpulan: Penggunaan absorbable barrier mesh secara bermakna menyebabkan rerata jumlah sel fibroblas, ukuran fibrosis, dan risiko perlengketan klinis yang lebih rendah paska tindakan decompressive craniectomy.