COMPARISON BETWEEN TECHNIQUE TENDON SUTURE MODIFIED SAMU MS AND MODIFIED
KESSLER MK TOWARDS TENDON SUTURE STRENGTHS
TENSILE STRENGTH
OF BROILERS TENDON
GALLUS
Nanang Muhibuddin Erni Rahmawati Moh Halili
STIKES BHAKTI MULIA PARE KEDIRI Email : nanang_dr80yahoo.co.id
Abstract Acute trauma at the arms, wrists, or fingers often cause the tendon rupture which certainly needs
strong and effective suture. Therefore, the researcher is going to compare the strengths between tendon suture Modified Samu technique and Modified Kessler technique. This research design
applied true experimental design through Pasca test in the first analysis and Prepost test for the second analysis. The samples of this research were 30 broilers which were categorized in
inclusive and exclusive criteria by using simple random sampling. The first analysis was to test the strength of tendon suture Modified Samu and Modified Kessler Technique, while the second
analysis was to test the effectiveness of tendon suture Modified Samu and Modified Kessler Technique. The data were collected through observation sheets which were suited to the
checklist then analyzed through Mann
–Whitney U-Test. After the research was conducted, tendon suture Modified Samu was 90 stronger than Modified Kessler technique, however, the
Modified Kessler Technique was 90 more effective than Modified Samu technique. Based on Mann
–Whitney U-Test in
þ
α 0,05 degree of suture strength, the score of
þ
0,02 was 0,05, while the suture effectiveness, the score of
þ
0,02 was 0,05. Regarding the results, it showed that Ho was rejected and H1 was accepted. It meant that there was significance difference of the
suture strengths and the suture effectiveness between tendon suture Modified Samu technique and Modified Kessler technique of broilers. Regarding the difference, it is expected for the
readers especially orthopedic surgeon to be able to use new technique which is Modified Samu in coordinating the tendon which got rupture.
Key words: suture technique, suture strength, suture effectiveness.
1. Background
One of the complicate problems in orthopedic surgery is to restore the normal
function of the finger with tendon rupture. Trauma of sharp on the arm, wrist and on
the fingers often cause tendon rupture, both flexor and extensor tendons. The success of
tendon graft surgery and rehabilitation is influenced by many factors. Among these
factors which are highly instrumental is the kind of trauma tendon, torn tendon sheath,
the tendon nutrition, shape and traumatic suture techniques, material and size of the
threads and postoperative immobilization of the related finger . The handling of tendon
rupture that is not optimal will result in tendon adhesion with surrounding tissue
that will interfere with tendon gliding, that
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finally result in impaired function of the related fingers, it can even occur rupture
again Rizal, 2010. The success in the implementation of
orthopedic surgery, especially in the tendon grafting, depending on the suture technique,
which is used. However, the use of the suture technique should pay attention to the
situation, the conditions and the shape or size of the tendon itself Surya, 2004.
From the research results of E. Surya D. Pohan, 2004, obtained a connection gap in
average load 1,269 kgf. While the results of the measurement of the difference in
circumference or diameter of the tendon, before and after healing sewn on average
0.75 mm. Where these studies using rabbit as a model. From the preliminary study
researchers concluded strength of the
tendon on the broiler, before doing the surgery grafting was 1,450 kgf.
Various experimental studies and clinical trials, previously concluded that
early mobilization of the tendon that has been spliced, would decrease the
occurrence rate of tendon adhesion with the surrounding tissue, and repair the tendon
gliding. However, early mobilization will cause the connection gap gap formation
larger, which facilitates the occurence of re-
Research benefits Theoretical benefits
1. Add a contribution in surgery 2. Being a new alternative materials that
better at connecting tendons. 3. Understand the technique of grafting
tendons. Practical benefits
rupture.
1.
For institution Connection gap is too large, and the re-
Provide information about the
rupture of the tendon that has been spliced, indicating a malfunction suture, it is
influenced by suture techniques, material and size of the threads as well as biological
and mechanical capabilities of the tendon, in the early stages of healing tendon. In the
techniques to sew the tendons that provide optimal results, so that in
surgery, especially orthopedic surgery can be used as guidelines on how or
techniques to sew the tendon.
first 2 weeks post-grafting, tendon suffered softening phase, where early mobilization
in this phase, increase the possibility of re- rupture. After the 3rd week, it gradually
becoming more and more powerful connections Sun, 2004.
According to Rizal 2010 that the increase in gap connections provide poor
clinical outcome. One target of the connecting tendon to repair or maintain the
gliding function. In tendon grafting, the addition of a connection circle has effect on
the gliding and then affecting mobilization after grafting.
Early mobilization in connection tendon, stimulate the surgeons hands to do
research, in order to get a strong tailoring techniques, while avoiding the occurrence
of a gap larger connection, which facilitates the re-rupture. Where, Kesler modification
technique is often used to compare with other techniques because according
Siverkiold Modified Kessler technique has advantages, such as the use of 4.0 prolene
2.
3.
4.
For nursing profession Nurse or other surgeons can choose
tendon suture technique that can provide good therapy in the treatment
of tendon rupture. For Public Clients who experiencing
Tendon Rupture Help clients in order that the fingers
or extremities which experience ruptured tendon, return to normal
function and prevent the occurence of rerupture of the tendon.
For researcher
By conducting this research, researchers can increase knowledge
about techniques of sewing the tendon. Researchers also can improve
the knowledge of researchers in applying science that has been
obtained by researchers directly into the environment. While for other
researchers can be used as a reference or as consideration for the next study.
yarn classified as small thread so that the addition of the connection circle minimal
4.10 mm. See the advantages - advantages that exist in Modified Kessler technique,
the researchers wanted to compare the results of his findings on the tendon suture
technique namely Samu Modification Techniques SM, which will be compared
with Kessler Modification Techniques KM
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Research Design
The research design used true experimental design in the form of post-test
on analysis I and prepost tests on the analysis II, with two treatments towards
broiler with the preparation of the flexor tendons, spliced with Samu Modification
techniques and Kessler modification technique. Use this kind of research,
