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FISIOLOGI PENYEMBUHAN

LUKA

woc c l i n i c
e
a P ro fe ssio n a l N u rse L e a d S e r vic e fo r P e o p le w ith S to m a s, W o u n d s o r In c o n tin e n c e
Ijin N o. 1 196/503/D inkes/B A K /X II/2007
MOIST WOUND HEALING
 George D Winter (1962): proved that wounds that were kept
moist, healed better than those that were exposed to the air.

THE FATHER OF MOIST


WOUND HEALING

Home WORK : Why MOIST ?


JUSTIFIKASI
1. Fibrinolisis : fibrin cepat hilang pada suasana lembab
oleh netrofil dan sel endotel

2. Angiogenesisi : proses akan lebih terangsang pada suasana lembab

3. Infeksi : lebih rendah dibandingkan suasana kering ( 2.6 % vs 7.1 % )

4. Percepatan pembentukan sel aktif : invasi netrofi yang diikuti oleh


makrophag, monosit dan limfosit ke daerah luka akan berfungsi
lebih dini.

5. Pembentukan growth factor : lebih cepat pada suasana lembab


* EGF, FGF dan Interleukin1 dikeluarkan oleh makrophag
untuk proses angiogenesis dan pembentukan str. Korneum
* Platelet-derived Growth Factor (PDGF) dan Transforming
Growth Factor-beta (TGF-beta) dibentuk oleh platelet untuk
proses proliferasi fibroblast.
TYPES OF WOUND HEALING
1. Healing by First Intention

2. Healing by Second
Intention

3. Healing by Third
Intention
Schematic Diagram of the
Phases of Wound Healing
CELLS OF WOUND HEALING.
INFLAMMATORY STAGE
 Tanda : kemerahan, panas,  24 jam pertama saat terjadi
nyeri dan bengkak perlukaan, neutrophils,
monocytes and macrophages
mengontrol pertumbuhan
 Last approximately 4 to 5 bakteri dan membuang
days jaringan mati (
mempersiapkan dasar luka )
 Permulaan terjadinya proses
penyembuhan luka :  Characteristic red color and
aktifitas platelet untuk warmth is caused by the
STOP perdarahan dan capillary blood system
triggers the immune increasing circulation &
response laying foundation for
epithelial growth
PROLIFERATION STAGE

 Begins within 24 hours of  Formation of new capillaries


the initial injury and may that generate and feed new
continue for up to 21 days tissue

 It is characterized by three  Granulation tissue is the


events: beefy red tissue that bleeds
 Epithelialization easily
 Granulation
 Collagen synthesis
PROLIFERATION : EPITHELIAZATION
 Formation of an epithelial
layer that seals and protects
the wound from bacteria
and fluid loss
 It is essential to have a
moist environment to foster
growth of this layer
 It is a very fragile layer that
can be easily destroyed with
aggressive wound irrigation
or cleansing of the involved
area
PROLIFERATION : COLLAGEN SYNTHESIS
 Creates a support matrix for
the new tissue that provides
it with its’ strength

 Oxygen, iron, vitamin C,


zinc, magnesium & protein
are vital for collagen
synthesis

 This stage is the actual


rebuilding and is influenced
by the overall patient
condition of the wound bed
MATURATION
 FINAL stage of wound
healing
 Begins around day 21 and
may continue for up to 2
years
 Collagen synthesis continues
with eventual closure of the
wound and increase in
tensile strength
 Tensile strength reaches only
about 80% of pre-injury
strength
5 HARI PASCA PERLUKAAN
REFFERENCE
 Idral Darwis.2008.Perawatan luka diabet.WOCARE
publishing. Indonesia
 Aida S.D. Suriadiredja.2007. History of wound healing
and moist wound healing. Indonesian ETNEP paper.(not
publication)
 Carville Kerylin.1998. Wound care manual. Silver chain
foundation.Australia
 Bryant Ruth.2007. Acute and chronic wound.
Mosby.USA