PEMAKAIAN KLINIS AMNION

Menkher Manjas MD, FICS

DR. M DJAMIL HOSPITAL TISSUE BANK Perintis Kemerdekaan Street PADANG WEST SUMATERA INDONESIA Ph/Fax + 62 751 30706

SELAPUT AMNION
Selaput luar ketuban diatas chorion Tipis & transparan

Fungsi Proteksi, nutrisi janin

Mengandung bahan- bahan nutrisi dan antiseptik untuk bayi

KETUBAN
1. Tidak dimanfaatkan
Dibuang Dikubur Dihanyutkan

2. Dimanfaatkan Diambil lapisan amnionnya

Biomaterial

AMNION
1. Bentuk : tipis , elastis , transparan 2. Sifat : Permeabilitas terhadap O2 & CO2 3. Mengandung zat kimia
1. Transferin
Mencegah rx imun Punya faktor angineogenik

2. 3.

Allantoin & Lisozome bersifat bakteriostatik Progesteron

SEDIAAN AMNION
1. Amnion Segar 2. Amnion radiasi (Radiation sterilized
lyophilized amniotic membrane)

Amnion Segar
Amnion yang langsung diambil dari placenta diolah dan dipergunakan untuk klinis
Bertahan hanya untuk lebih kurang 1 minggu Tidak steril

Amnion Radiasi
Amnion yang sudah diproses pada bank jaringan Sterilisasinya secara radiasi (Radiation sterilized lyophilized amniotic membrane) Dapat disimpan dalam waktu lama Dapat dipergunakan kapan saja

Tahap Proses Amnion Radiasi

1. Pengambilan ketuban 2. Pelepasan amnion

3. Pencucian
4. Lyopilisasi pengeringan pada kondisi beku tanpa melewati fase cair shg tak merusak fisik dan biokimia jaringan 5. Packing KGy

6. Radiasi sterilisasi dengan sinar gamma 25

Kegunaan Klinis Amnion

1.Penutup

Luka (Redresing Luka)

(Biological Wound redressing)

2.Allograft

Amnion Sebagai Redresing

1. Luka bakar

2. Ulkus Diabetikum
3. Decubitus 4. Luka terbuka 5. Penutup luka paska operasi / Sirkumsisi

Amnion Sebagai Allograft

1. Penutup luka skin graft 2. Pasca operasi mata

3. Penutup membrana tympani

4. Vaginoplasty 5. Urethroplasty

Amnion Sebagai redresing Luka

1. Tidak ada Resistensi dari tubuh

2. Mempercepat penyembuhan luka

3. Kemampuan angiogenik p darah baru

4. Mengurangi rasa nyeri

5. Pemakaian lama side efek (-) 6. Menekan pertumbuhan kuman (Invivo /invitro)

Keunggulan Amnion sebagai redresing luka

Lengket dengan luka mengurangi evaporasi cairan , protein dan panas
Elastis & lunak Tanpa perlu redresing skunder Dapat dihancurkan oleh kuman

Tersedia dan tersimpan lama Amnion radiasi

TISSUE BANK RSUP DR M JAMIL PADANG

Satu instalasi di RS yang bertanggung jawab dalam mencari, mengolah jaringan donor dan selanjutnya memproses sehingga dapat dipergunakan untuk kepentingan pengobatan.

SEJARAH BERDIRINYA TB M DJAMIL

1972 Amnion segar LB derajat II.

1993 Penelitian amnion radiasi (BATAN)

1996-1997 Bantuan sarana dari IAEA & BRTB 1994 Penataran tenaga (Dalan & Luar negeri). 1 Juli 1997 Produksi pertama 28 Oktober 1998 diresmikan oleh Menkes

TISSUE BANK ACTIVITIES

1. Processing , storage and distribution of human tissues for medical uses. 2. Sterilisasi alat-alat kesehatan 3. Research
Medical Non medical

TISSUE BANKING SYSTEM, 2000

NATIONAL NETWORK IN INDONESIA
CIPTO HOSPITAL JAKARTA SOETOMO HOSPITAL TISSUE BANK SURABAYA 50 HOSPITAL
FATMAWATI HOSPITAL JAKARTA

BATAN RESEARCH TISSUE BANK (BRTB)

SUBROTO ARMY HOSPITAL JAKARTA

SIAGA RAYA ORTHOPAEDI HOSPITAL JAKARTA

M DJAMIL HOSPITAL TISSUE BANK PADANG 6 HOSPITAL

National Coordinator

EYE HOSPITAL IN JAKARTA AND AROUND INDONESIA

Other : PALEMBANG, MAKASAR, MALANG JOGJA

LEPROSY HOSPITAL TANGERANG

Consultations and raw material Finished products, information,s and training Consultation, irradiation and information

Pemakaian Amnion pada Luka bakar

Kamardi Thalut, Nursal Hasbi Pemakaian klinis Amnion radiasai pada luka bakar 1995
Jum kasis : 30 pasien luka bakar Kesimpulan Amnion merangsang pertumbuhan jaringan epitel kulit, jaringan granulasi dan pertumbuhan kapiler baru.
Presented at Asian Surgical Association 10th Bienial Congress 12-16 March Bali Indonesia

Pemakaian Amnion Pada Penutupan Luka pasca Sectio Caesaria

Helfial Helmi, Menkher Using amniotic membrane as wound covering after caesarean section operation 2000

No of case : 196 pregnant women Age : 26 to 38 y.o. Conclusion Amnion (as wound covering post cesarean) Overall results are good No severe complication No wound dehiscence, No allergic reaction
Presented at 8th International Conference On Tissue banking in cooperation with International Atomic energy October 22-24, 2000 Bali Indonesia

Pemakaian Amnion Sesudah Sirkumsisi

Menkher, Ismal, Doddy Efmansyah

Experience of using amniotic after circumcision

No of case : 165 boys Age : 6-10 yo. Conclusion Amnion (as wound covering post circumcision): No complication (Local Simple method Available

infection & Allergic Reaction)

Presented at 8th International Conference On Tissue banking in cooperation with International Atomic energy October 22-24, 2000 Bali Indonesia

Pemakaian Amnion Sesudah Sirkumsisi

Yulfirsta , Doddy Efmansyah, Erkadius

Pemakaian amnion sebagai penutup luka pasca sirkumsisi (2001)

Jum kasus Umur : : 16 boys 6-10 yo.

Kesimpulan Amnion sebagai penutup luka pasca sirkumsisi Mengurangi nyeri Tidak perlu redresing ulang Langsung mobilisasi
Final paper as surgery training Medical Faculty Andalas university 2001

Pemakaian Amnion Pada Skin Graft

Arsil Hamzah , Menkher Manjas

Studi perbandingan pemakaian amnion dengan sofratulepada luka donor skin graft. (1999)
Jumlah kasus 52 pasien

Kesimpulan Amnion mempercepat penyembuhan terbentuknya jaringan keloid .

luka

dan

mengurangi

Amnion For Skin Graft

Menkher Manjas , Arsil Hamzah

Comparison studies of using radiation amnion and sofratule in host of skin graft. (1999)
No of cases 52 patients

Conclusion Amnion promoted wound healing and scar formation.

Multilayered Amniotic Membrane Transplantation for the Treatment of Corneal Epithelial Defects and Ulcers

Getry Sukmawati, Ibrahim S Department of

Ophthalmology Faculty of Medicine Andalas University/M Djamil Hospital

PEMAKAIAN AMNION LYOPHILISASI STERIL RADIASI SEBAGAI PERBAN BIOLOGIS PADA TUKAK DIABETES

JEFRI HENKY Dr.H. MENKHER MANJAS, Sp.B. Sp.OT. FICS.

Clinical Application Of Bone graft

Menkher Manjas, Nazly Hilmy

Rejection study of cancelous allograft in emergency orthopedic operation (2000)

No of cases : 40 patients Conclussion Allograft significantly increased callus formation.
Presented at 8th International Conference On Tissue banking in cooperation with International Atomic energy October 22-24 ,2000 Bali Indonesia

Menkher Manjas, Nazly Hilmy

Comparison studies on rejection and bone healing of radiation sterilized cancelous allograft and xenograft in orthopedic operation (2002)
No of cases 64 patients Conclusion Xenograft and allograft, have same effect of increased callus formation.
Presented at 8th International Conference On Tissue banking in cooperation with International Atomic energy October 22-24 ,2000 Seoul Korea

IS AMNION CREAM ALSO EFFECTIVE IN COLLAGEN FORMATION FOR WOUND HEALING

(WISTAR RATS WOUND EXPERIMENTAL STUDIES)

Menkher Manjas Fathar Usman Salmiah Agus

Dr. M Djamil Hospital Tissue Bank, Dept. Of Surgery
Faculty Of Medicine Andalas University Padang

INDONESIA
Dept. Of Pathologic Anatomy Faculty University Padang INDONESIA Of Medicine Andalas

11th International Conference Asia Pacific Association Of Surgical Tissue bank 24th-26 th Nov 2006 Mumbai India

Non Medical Research

1. Henni Agusmira (Agriculture Faculty Andalas University1999) Effect of Cobalt 60 type radiation for Aspergilus mutan to increase citric acyd production from residual tapioca 2. Jumniah (Post graduate Agriculture Faculty Sriwijaya University1999) Radiation effect of soybean in increasing production 3. Yopi Sartika (Faculty Of Chemistry Andalas University 2000) Over production of citric acyd after radiation glukosamine mutan aspergilus niger 4. Susi Djamhari ( Internal Medicine Department Medical Faculty Andalas University 2000) Comparison studies of freeze chondroitin sulfat and piroksikam in osteoarthritis of the knee