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    Parade Bedah Plastik

    Uploaded by

    Minarni Ho
    parade bedah plastik di RSHS Bandung dilakukan setiap minggu untuk assesment pasien pasien dalam ruangan.

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    © All Rights Reserved
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    Parade Bedah Plastik

    Uploaded by

    Minarni Ho
    82 views28 pages
    parade bedah plastik di RSHS Bandung dilakukan setiap minggu untuk assesment pasien pasien dalam ruangan.

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    parade bedah plastik

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    parade bedah plastik di RSHS Bandung dilakukan setiap minggu untuk assesment pasien pasien dalam ruangan.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    82 views28 pages

    Parade Bedah Plastik

    Uploaded by

    Minarni Ho
    parade bedah plastik di RSHS Bandung dilakukan setiap minggu untuk assesment pasien pasien dalam ruangan.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 28

    KM 2 dan Kenanga

    Dr. Almahitta, Sp.BP(RE)K

    Baby M. Shiddiq / 2 month / MR.


    15035621 / kenanga 1
    Admission : October 10th, 2015
    Consultant : Almahitta, dr., SpBP-RE
    Working Diagnosis :
    Hidrocephalus communicans
    Pressure ulcer a/r occipitalis
    Present State
    State
    RR
    : 45x/min
    HR
    : 140 x/min

    Temp : 36,9oC

    Local state
    a/r occipitalis : multiple wound biggest size
    10x4cm, smallest size 5x5cm, irregular edge,
    pus (-), slough (-), bledding (-)

    Clinical picture 26/11/2015

    Clinical picture 29/11/2015

    Clinical picture 4/12/15

    Clinical picture 7/12/15

    Clinical picture 21/12/2015

    Laboratory Finding
    Lab

    18/11/1 20/11/1 23/11/1 27/11/1 2/12/15 16/12/1


    5
    5
    5
    5
    5

    PT/
    APTT/
    INR
    Hb

    12,7

    11,7

    11,2

    12

    9.1

    Ht

    38

    34

    33

    35

    27

    Leucosit

    10.800

    14.800

    14.100

    14.400

    13.200

    Trombosi
    t

    453.000 490.000 513.000 320.000

    SGOT/
    SGPT
    Ur/ Cre
    Blood
    Glucose

    79

    Na/K

    137/3,9

    Alb/Proto 2,7/5,2

    132/4,1

    135/5.4
    2.8/5.0

    Pus culture
    (30/11/2015)

    Founded
    1.
    Acinetobacter baumanii

    Antibiotic

    Org.1

    Amikacin

    Ampicilin Sulbactam

    Aztreonam

    Cefepime

    Ceftazidime

    Ceftriaxone

    Cephazolin

    Cotrimoxazole

    Gentamycin

    Meropenem

    Piperacillin
    Tazobactam

    Tigecyclin

    Management

    Wound hygiene
    Head Mobilization

    Wound care with duoderm gel every 2 -3 days


    Antibiotic and another therapy according to Pediatric
    department

    Mr. Odang / 42 y.o / MR. 15028619 /


    Kemuning 2 Ortho
    Admission : December 7th, 2015
    Consultant : Almahitta, dr., SpBP-RE
    Working Diagnosis :
    Post escharectomy at left hand + amputation of the right 5 th toe POD
    8 due to Electrical Burn Injury grade 2-3 with raw surface 7,25% at
    bilateral superior and inferior extremity that had been performed
    amputation of the right arm below elbow
    Suspect fracture left thigh
    Operating History
    1st Necrotomy Debridement & amputation of the little toe on
    December 14th, 2015
    December 22th Amputation of the right arm below elbow
    Present State
    State 4
    BP
    : 138/78 mmHg
    HR
    : 87 x/min

    RR : 22x/min
    Temp : 37,3oC

    Clinical picture 20/12/2015

    Clinical picture 20/12/2015

    Post Op 21/12/2015

    Laboratory Finding
    Lab
    PT/
    APTT/
    INR

    7/12/1
    5

    10/12/
    15

    12/12/
    15

    10,0

    9,6

    Ht

    32

    29

    28

    Leucosi
    t

    15.900

    18.700

    19.300

    Trombo
    sit

    274.00
    0

    366.00
    0

    429.00
    0

    SGOT/
    SGPT

    45/74

    62/61

    Na/K
    Alb/Prot
    ot

    AGD
    pH

    11,4

    Blood
    Glucose

    14/12/
    15

    10,9/23
    ,8/0,98

    Hb

    Ur/ Cre

    13/12/
    15

    116
    125/4,3 122/3,8 125/3,3 123/3,4 126/3,6
    3,0

    2,6

    10/1
    2/15

    12/1
    2/15

    7,516 7,426 7,513

    pCO2

    28,3

    33,3

    28,0

    pO2

    78,8

    73,9

    84,8

    HCO3

    22,4

    21,6

    22,0

    TCO2

    42,3

    50,4

    41,6

    1,5

    -1,6

    1,1

    95,8

    95

    96,6

    BE
    SaO2

    25/0,59 20/0,63

    7/12/
    15

    Laboratory finding
    Lab

    21/12/15

    PT/APTT/INR

    13/40.3/1.07

    Hb

    9.2

    Hct

    28

    Leukosit

    9.800

    Trombosit

    597.000

    Ur / Cr

    24/0.57

    Na / K

    133/3.7

    SGOT/SGPT

    42/63

    RBG

    143

    Alb/Tot. Prot.

    2.7/6.4

    Management

    Vital sign observation


    IVFD NaCl 0,9% 1500cc/24 hr
    Ceftriaxone inj 1x2 g iv
    Ranitidine inj 2x50 mg iv
    Tramadol inj 3x30 mg iv
    Wound dressing with duoderm gel + tulle POD 3
    High protein diet
    Consult to Rehabilitation Departement

    THANK YOU

    Alfian/ / 5 y.o / MR. 15027968


    Admission : November 10th , 2015
    Consultant : dr. Almahitta, SpBP-RE
    Working Diagnosis :
    Post necrotomy debridement and skin graft due to neglected burn injury
    grade 2AB 11% ec scald with raw surface 2.5%
    Anemia due to blood loss
    Hypoalbuminemia due to low nutrition intake
    Past surgical history:
    13 November 2015: necrotomy debridement
    19 November 2015: skin graft
    26 November 2015: ND + STSG
    07 December 2015: ND + STSG
    11 December 2015 : ND
    18 December 2015 : ND
    Present State :
    Fully alert
    RR
    : 22 x/min,
    HR
    : 95 x/min
    Temp
    : 36,7 oC

    07.12.15

    11.12.15

    18.12.15

    21.12.15

    Pus culture for bacterial resista


    Antibiotic

    Nov 13rd
    2015

    Nov 20rd
    2015

    Nov 25rd
    2015

    Amikacin

    Ampicillin
    Sulbactam

    Aztreonam

    Cefepime

    Ceftazidime

    Ceftriaxone

    Cephazolin

    Ciprofloxacin

    Cotrimoxazole

    Gentamycin

    Meropenem

    Piperacillin
    Tazobactam

    Pseudomonas aeruginosa

    Management
    Vital sign observation
    IVF RL:D5= 2:1 = 1000 cc/24 hrs
    High protein and calorie diet
    Therapy:
    Ceftazidime 3 x 150 mg IV
    Paracetamol syrup 3-4 x 2 cth PO prn

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