Scribd Logo
Upload

Welcome to Scribd!

  • Parade Tn. Ade AKA

    Uploaded by

    itang itang
    18 views17 pages
    The document describes the hospital admission of Mr. Ade Soetrisno from January 13 to February 1, 2021. He has a chronic wound on his right chest that has required multiple surgeries including debridement and skin grafting. His most recent procedure on January 29 addressed the recurrent wound. His vital signs were stable during admission and he was managed with IV antibiotics and wound care.

    Original Description:

    Copyright

    © © All Rights Reserved

    Available Formats

    PPTX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    The document describes the hospital admission of Mr. Ade Soetrisno from January 13 to February 1, 2021. He has a chronic wound on his right chest that has required multiple surgeries including debridement and skin grafting. His most recent procedure on January 29 addressed the recurrent wound. His vital signs were stable during admission and he was managed with IV antibiotics and wound care.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pptx, pdf, or txt
    18 views17 pages

    Parade Tn. Ade AKA

    Uploaded by

    itang itang
    The document describes the hospital admission of Mr. Ade Soetrisno from January 13 to February 1, 2021. He has a chronic wound on his right chest that has required multiple surgeries including debridement and skin grafting. His most recent procedure on January 29 addressed the recurrent wound. His vital signs were stable during admission and he was managed with IV antibiotics and wound care.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pptx, pdf, or txt
    of 17

    Mr. Ade Soetrisno, Male, 71 y.

    o (07/08/49)
    0001351115 / NHI
    Consultant : Dr. dr. Lisa Hasibuan, SpBP-RE(K)
    Re-admitted : 13/01/2021 – RIK 2.11

    Diagnosis:
    • Chronic wound e.c. Fascitis Necrotican Recurrent a.r. hemithorax dextra Post Re - ND +
    STSG POD 3
    Mr. Ade Soetrisno, Male, 71 y.o (07/08/49)
    0001351115 / NHI
    Consultant : Dr. dr. Lisa Hasibuan, SpBP-RE(K)
    Re-admitted : 13/01/2021 – RIK 2.11

    Surgery History:
    • ND (RSHS, 03/12/20)
    • ND, biopsy, close defect with STSG, NPWT (RSHS, 10/12/20)
    • ND, close defect with STSG (RSHS, 19/12/20)
    • ND, close defect with STSG (RSHS, 19/01/21)
    • ND, close defect with STSG (RSHS, 29/01/21)

    General Status
    • Alert
    • BP 110/80 mmHg HR 80 x/minute, regular RR 20 x/minute (SpO2 99%) S 36.7 oC
    Mr. Ade Soetrisnao Male, 71 y.o (07/08/49)
    0001351115 / NHI
    Consultant : Dr. dr. Lisa Hasibuan, SpBP-RE(K)
    Re-admitted : 13/01/2021 – RIK 2.11

    Admission 13/01/2021
    Mr. Ade Soetrisnao Male, 71 y.o (07/08/49)
    0001351115 / NHI
    Consultant : Dr. dr. Lisa Hasibuan, SpBP-RE(K)
    Re-admitted : 13/01/2021 – RIK 2.11

    16/01/2021
    Mr. Ade Soetrisnao Male, 71 y.o (07/08/49)
    0001351115 / NHI
    Consultant : Dr. dr. Lisa Hasibuan, SpBP-RE(K)
    Re-admitted : 13/01/2021 – RIK 2.11

    Pre Op 19/01/2021
    Mr. Ade Soetrisnao Male, 71 y.o (07/08/49)
    0001351115 / NHI
    Consultant : Dr. dr. Lisa Hasibuan, SpBP-RE(K)
    Re-admitted : 13/01/2021 – RIK 2.11

    Intra Op 19/01/2021
    Mr. Ade Soetrisnao Male, 71 y.o (07/08/49)
    0001351115 / NHI
    Consultant : Dr. dr. Lisa Hasibuan, SpBP-RE(K)
    Re-admitted : 13/01/2021 – RIK 2.11

    Post Op 19/01/2021
    Mr. Ade Soetrisnao Male, 71 y.o (07/08/49)
    0001351115 / NHI
    Consultant : Dr. dr. Lisa Hasibuan, SpBP-RE(K)
    Re-admitted : 13/01/2021 – RIK 2.11

    22/01/2021
    Mr. Ade Soetrisnao Male, 71 y.o (07/08/49)
    0001351115 / NHI
    Consultant : Dr. dr. Lisa Hasibuan, SpBP-RE(K)
    Re-admitted : 13/01/2021 – RIK 2.11

    25/01/2021
    Mr. Ade Soetrisnao Male, 71 y.o (07/08/49)
    0001351115 / NHI
    Consultant : Dr. dr. Lisa Hasibuan, SpBP-RE(K)
    Re-admitted : 13/01/2021 – RIK 2.11

    29/01/2021 (Pre-Op)
    Mr. Ade Soetrisnao Male, 71 y.o (07/08/49)
    0001351115 / NHI
    Consultant : Dr. dr. Lisa Hasibuan, SpBP-RE(K)
    Re-admitted : 13/01/2021 – RIK 2.11

    29/01/2021 (Post-Op)
    Mr. Ade Soetrisnao Male, 71 y.o (07/08/49)
    0001351115 / NHI
    Consultant : Dr. dr. Lisa Hasibuan, SpBP-RE(K)
    Re-admitted : 13/01/2021 – RIK 2.11

    01/02/2021
    Chest X-Ray AP
    RSHS, 13/01/2021
    ECG
    RSHS, 14/01/2021
    Laboratory Result
    No
    Parametric Normal 13/1/21 17/01/21 24/01/21 28/01/21 29/01/21
    .
    1 Hemoglobin 14.00-17.4 9.0 10.8 10.0 10.9 9.8
    2 Hematokrit 41.5-50.4 27.3 32.8 30.9 31.9 28.8
    3 Leukosit 4500-11000 11.290 13.720 21.800 15.540 17.620
    4 Trombosit 150000-450000 354.000 404.000 533.000 213.000 183.000
    PT/APTT/IN 9.1-13.1 / 14.2-34.2 / 11.1 / 24.8 /
    5 - - - -
    R 0.8-1.2 1.00
    6 GDS <140 178 - - - -
    7 GD2PP <140 - 90 - - -
    8 HbA1c 4.5-6.2 - 7.3 - - -
    9 SGOT/SGPT 15-37/16-63 22 / 30 - - - -
    10 Albumin 3.4-5.0 2.30 2.87 - - 1.77
    Ureum /
    11 15.0-39 / 0.80-1.30 - - - - -
    Creatinine
    12 Natrium 135-145 - - - - 132
    13 Kalium 3.5-5.1 - - - - 3.3
    PCR SARS
    14 Non reactive Non reactive - - - -
    Cov 2
    Laboratory Result
    No
    Parametric Normal 30/1/21 01/02/21
    .
    1 Hemoglobin 14.00-17.4
    2 Hematokrit 41.5-50.4
    3 Leukosit 4500-11000
    4 Trombosit 150000-450000
    PT/APTT/IN 9.1-13.1 / 14.2-34.2 /
    5
    R 0.8-1.2
    6 GDS <140
    7 GD2PP <140
    8 HbA1c 4.5-6.2
    9 SGOT/SGPT 15-37/16-63
    10 Albumin 3.4-5.0 2.21 2.62
    Ureum /
    11 15.0-39 / 0.80-1.30
    Creatinine
    12 Natrium 135-145
    13 Kalium 3.5-5.1
    PCR SARS
    14 Non reactive
    Cov 2
    Mr. Ade Soetrisnao Male, 71 y.o (07/08/49)
    0001351115 / NHI
    Consultant : Dr. dr. Lisa Hasibuan, SpBP-RE(K)
    Re-admitted : 13/01/2021 – RIK 2.11

    Management
    Plastic Surgery Division
    - IVFD NaCl 0.9% 1500 ml/24 hours
    - Diet of low sodium, High protein
    - Ampicilin-sulbactam 4x1.5 gr IV
    - Omeprazole 2 x 40 mg IV
    - Mefenamic acid 3 x 500 mg PO
    - Wound toilette with tulle, fluffy gauze, tie
    over, hypafix; next POD 6 (tgl 04-02-
    2021)

    You might also like