PENANGANAN LUKA BAKAR

Muskhab Eko R.,

S.Kep., M.Kep., Ns.
Review
Penanganan
 Surgical (bedah)
 Non Surgical (non bedah)
 SURGICAL
 Escharotomy
 Excision of the Burn Wound
 Skin Grafts
 Non Surgical
 Management of Infection
 Management of Depth of Burn
 Escharotomy
Is a medial and
lateral surgical
incision
through the
depth of the
eschar with a
scalpel
 Goal of the escharotomy
The goal is to allow expansion of the
subdermal space, decompres the
subdermal tissue and decrease
constriction on vascular and nerve
structures
Excision of the burn wound

The surgical procedure of

removing the burn eschar
Excision of the burn wound
Skin Grafts
is a section of skin
that is surgically
removed from one
area of the body
(donor site) and
transferred to
another area to cover
an area of damaged
or missing skin.
The purposes of a Skin Graft
Lessen the
potential for
infection
Minimize fluid
loss by
evaporation
Hasten recovery
Reduce scarring
Skin Graft
Skin Graft
Mesher
Management of Infection
The trend is to change the wound dressing once a day
to minimize pain. More frequent dressing changes
occur when the wound is infected or when there is
significant saturation with wound exudates.
 Topical Antibacterial Agents Used for Burn Wounds
Agent Indication

Silver sulfadiazine 1% • Most bactericidal agent

(Silvadene) - watersoluble • Minimal penetration of eschar
cream
Mafenide acetate 5% • Effective against gram-negative and gram-positive
to 10% (Sulfamylon) organisms
- hydrophilic-based • Diffuses rapidly through eschar
cream • In 10% strength, it is the agent of choice for electrical
burns because of its ability

Silver nitrate 0.5% • Bacteriostatic and fungicidal

- aqueous solution • Does not penetrate eschar

Acticoat • Effective against gram-negative

and gram-positive organisms
Management depth of the burn
Superficial Thickness
Burns
The care of a superficial-
thickness burn is simple,
often requiring only the
application of a moisturizer
on the wound. The goal is to
provide an environment
that encourages
reepithelialization of the
wound.
Partial-Thickness Burns
First, they should be
cleansed. It is generally felt
that small, sturdy blisters can
be left intact, but large or
fragile blisters should be
debrided. If there is a concern
about infection, then an
antibacterial agent may also
be applied to the wound
surface. The most common
antimicrobial agents used on
partial-thickness wounds are
ointments or creams.
Full-Thickness Burns
Debridement of full-
thickness burn wounds is
accomplished in the
operating room as part of
surgical excision and skin
grafting.
The clinician’s goal is
therefore to prepare the
wound for surgical
management by controlling
infection
Conclusion
The etiology, depth, location and size of a burn injury
are important in understanding the treatment plan for
patients with burns.
 Kasus
Seorang laki – laki berusia 45 tahun dirawat di pusat luka bakar.
Berdasarkan asessment perawat didapatkan data ; luas luka bakar
54%, derajat 3, di kedua lengan dan dada serta perut. Eschar tampak
jelas di lengan kanan pasien. Dokter memberikan advice yaitu
melakukan insisi di medial dan lateral lengan pasien tersebut untuk
mengurangi konstriksi pembuluh darah.

Apakah tindakan yang dimaksud berdasarkan kasus diatas ?

A. Debridement
B. Escharotomy
C. Laparatomy
D. Skin Graft
E. Eksisi
 SEKIAN
&
TERIMA KASIH
Referensi
Baranosky, Sharon., Ayello, Elizabeth A. (2012). Wound
Care Essentials Practice Principles 3rd Edition.
Lippincott Williams & Wilkins. Philadelphia