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Mar 03

Proses Penyembuhan Luka

Proses penyembuhan luka adalah fenomena yang sangat menakjubkan. Proses tersebut melibatkan banyak faktor yang mempengaruhi termasuk kondisi fisik dan psikologis seseorang,  dan ternyata faktor psikologis dapat menyebabkan proses penyembuhan kian lama. sebagai contoh: seorang yg mempunyai luka yg tidak terlalu besar namun mengalami proses penyembuhan yg lama, dan setelah dikaji lebih lanjut ternyata pasien tersebut mengalami gangguan secara psikologis dimana dia takut akan kematian, dan hal tersebutlah yg ternyata  membuat proses penyembuhan luka menjadi lama. maka tak heran ketika orang tersebut memiliki waktu penyembuhan yang lebih lama di banding dengan yang lain

Tiga tahapan itu harus dilewati pada semua jenis luka dan juga harus sesuai dengan waktu/lamanya setiap fase penyembuhan luka, untuk fase haemostasis diperlukan waktu 3-4 hari dan ditandai dengan kemerahan pada luka, bengkak, nyeri.  Pada fase ini luka dibersihkan secara  alamiah oleh tubuh dgn bantuan pasukan2nya ( netrofil, sel magrofag dll). Setelah proses ini berakhir maka akan didapatkan luka yang bersih,tidak terdapat kuman. Selanjutnya luka memasuki fase proliferative, pada fase ini akan terjadi pembelahan sel/proloferasi, pada fase ini fibroblast  sangat berperan dalam proses perbaikan yaitu bertanggung jawab menghasilkan produk-produk struktur protein yang digunakan selama proses rekonstruksi jaringan, fase ini berlangsung sampai hari ke 21.

Pada jaringan lunak yang sehat fibroblast tidak aktif bergerak, namun ketika terjadi luka maka fibroblast akan mengeluarkan substansinya (kolagen, elastin, hyaluronic acid, fibronectin dan proteoglicans yg berperan dalam membangun jaringan baru.

Fungsi kolagen adalah membentuk cikal bakal jaringan baru sehingga terbentuknya jaringan granulasi.

Pada fase ini juga berlangsung proses angiogenesis yaitu suatu proses pembentukan pembuluh kapiler baru, kegagalan membentuk angiogenesis akan berdampak pada lambatnya proses penyembuhan luka. Pada fase ini fibriplasia dan angiogenesis merupakan proses yang terintegrasi dan dipengaruhi oleh substansi yg dikeluarkan oleh platelet dan magrofag.

Proses selanjutnya adalah epitelisasi, dimana fibroblast mengeluarkan Keratinocyt Growth Factor (KGF) yang berperan dalam stimulasi mitosis sel epidermal. Keratinisasi akan dimulai dari pinggir luka dan akhirnya menutupi seluruh luka.Fase proliferasi normal terjadi sampai hari ke 21. Selanjutnya luka memasuki fase Maturasi. Fase maturasi berfungsi menyempurnakan bentuk jaringan baru menjadi jaringan penyembuhan luka yang kuat dan bermutu, Fibroblast sudah mulai meninggalkan jaringan granulasi, warna kemerahan dari jaringan sudah berkurang karena pembuluh sudah berkurang dan serat fibrin dan kolagen sudah bertambah banyak untuk memperkuat jaringan parut.

Sintesa kolagen akan terus barlangsung pada fase ini, selain juga proses pemecahan kolagen juga terjadi, kolagen muda yang terbentuk pada fase proliferasi akan berubah menjadi kolagen tua pd fase maturasi pada fase ini. Dan untuk mencapai hasil yang optmal maka harus terjadi keseimbangan antara kolagen yg dihasilkan dengan kolagen yang dihancurkan. Kolagen yang berlebihan akan menjadi jaringan parut. Luka dikatakan sembuh jika telah terjadi kontinuitas lapisan kulit dan kekuatan jaringan parut sehingga pasien  mampu melakukan aktivitas normal.

Meskipun proses penyembuhan luka sama bagi tiap orang namun hasil  yang dicapai sangat individual tergantung dari lokasi serta luasnya luka, usia, kondisi fisik dan psikologis serta menyakit penyerta.

Fase remodeling ini berlangsung sejak minggu ke3 sampai 1 tahun.

Dengan memahami proses penyembuhan luka diharapkan perawat mampu merawat luka dengan baik dan mampu menganalisa proses penyembuhan luka yg sedang terjadi, sehingga setiap fase penyembuhan luka terlewati dengan baik sehingga lukapun dapat sembuh dengn baik .

Jika menemukan luka yang tak kunjung sembuh dimana fase-fase penyembuhan luka tidak terlewati dengan baik maka jangan ragu untuk segera menghubungi perawat spesialis luka  atau klinik perawatan luka agar luka anda segera pulih.

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