Perbandingan Efektivitas Klorheksidin 2% dalam Isopropil Alkohol 70% dengan Antiseptik Sesuai Prosedur Operasional Standar pada Persiapan Pembedahan

Abstract

Abstrak Untuk mencegah Infeksi daerah operasi, dilakukan persiapan kulit pasien sesaat sebelum pembedahan. Antiseptik preparasi pembedahan pada Prosedur Operasional Standar (POS) terdiri atas tiga rejimen yaitu sabun klorheksidin 4%, povidon iodin dan isopropil alkohol 70%. Oleh karena itu, perlu dilakukan penilaian efektivitas klorheksidin – isopropil alkohol sebagai kandidat bahan preparasi pembedahan yang lebih sederhana. Desain penelitian adalah studi potong lintang pada pasien operasi bersih terkontaminasi elektif <3 jam di RSUPN Dr. Cipto Mangunkusumo selama periode Juni hingga Agustus 2014. Terdapat dua kelompok perlakuan persiapan kulit yaitu menggunakan klorheksidin 2% dalam isopropil alkohol 70% dan kelompok antiseptik sesuai POS. Spesimen swab kulit diambil sebelum dan sesudah persiapan kulit, kemudian dihitung dan dibandingkan jumlah koloni bakteri. Dari 40 pasien kelompok antiseptik uji dan 42 pasien kelompok antiseptik sesuai POS menunjukkan perbedaan bermakna pada hitung koloni sebelum dan sesudah pemberian klorheksidin 2% dalam isopropil alkohol 70% (p=0,45, uji Mann Withney) dan pemberian antiseptik sesuai POS (p=0,15). Tidak terdapat perbedaan efektivitas kelompok yang mendapat klorheksidin 2% dalam isopropil alkohol 70% dibandingkan kelompok yang mendapat antiseptik sesuai POS (p>0,05). Larutan klorheksidin 2% dalam isopropil alkohol 70% sama efektifnya dengan antiseptik sesuai POS dalam preparasi kulit sebelum operasi sehingga dapat menjadi pilihan karena penggunaannya lebih sederhana dan lebih murah.
Kata kunci: klorheksidin 2%, isopropil alkohol 70%, preparasi kulit, antiseptik

Abstract To prevent Surgical Site Infection, skin preparation should be done before surgery. Antiseptic used in skin preparation according to Standard Operating Procedure (SOP) consists of three regimens consist of 4% chlorhexidine soap, povidone iodine and 70% isopropyl alcohol. Therefore, it is necessary to assess the effectiveness of chlorhexidine - isopropyl alcohol as a candidate for a simpler skin preparation material. The study design was a cross-sectional study in patients who were subjected to elective contaminated clean surgery <3 hours at RSUPN Dr. Cipto Mangunkusumo during June to August 2014. There were two groups of skin preparation treatments using chlorhexidine 2% in 70% isopropyl alcohol and the antiseptic group according to SOP. Skin swab specimens were taken before and after skin preparation, then bacterial colonies count were done. The results were analyzed using SPSS 20.0. Of the 82 patients who met the inclusion criteria, both SOPs antiseptic and tested antiseptic group consisted of 40 patients and 42 patients respectively. there was significant differences in colony count before and after administration of 2% chlorhexidine in 70% isopropyl alcohol (p = 0.45 and antiseptic administration according to POS (p = 0.15). There was no significant difference in the effectiveness of the group that received 2% chlorhexidine in 70% isopropyl alcohol compared to the group that received POS antiseptics (p> 0.5). It was concluded that a 2% chlorhexidine gluconate solution in 70% isopropyl alcohol was as effective as the use of three SOP regimens in skin preparation before surgery and can be an option because its use is simpler and cheaper.
Keywords: 2% chlorhexidine, 70% isopropyl alcohol, skin preparation, antiseptic