IMPLANT

Apriadi
NIM. FAA 111 0019

IMPLANT CONTRACEPTION
Contraception

is a method to prevent

pregnancy.
Implant is a contraceptive containing
levonorgestrel were wrapped in capsule
silasticsilikon (polidemetsilixane) and
inserted under skin.
Implant is a method of contraception that
contains only progestin with a long acting,
low dose and reversible for women.

Types of Implants
a.

b.

Norplant
Consists of 6 soft silastic hollow rod with a length of 3.4
cm, and diameter of 2.4 mm, were filled with 36 mg
levonogestrel, effective for 5 years.
Implanon
Consists of 1 white flexible rod with a length of
approximately 40 mm, and a diameter of 2 mm, which is
filled with 68 mg of 3- keto- desogestrel and effective for
3 years.

c. Jadena and Indoplant

Consists of 2 rods are filled with 75 mg
levonogestrel and effective for 3 years.

Advantage
The

performance high.
Long-term protection (up to 5 years).
Return of fertility levels quickly after
revocation.
Free from the influence of estrogen.
Do not interfere with breastfeeding.
Can be revoked at any time according to
need.

Disadvantage
Insertion

and expenditure must be carried out

by trained personnel.
Medical officers require training and practice for
the insertion and removal of the implant.
More expensive costs.
Often resulting changes in menstrual patterns.
Acceptor can not stop at will implant itself.
Some women may be reluctant to use it
because it is less known him.
Implant can sometimes be visible to others.

Mechanism of Implant
a.
b.

c.
d.

Cervical mucus becomes thick

Disrupt the process of formation of the
endometrium and it is difficult to
implantation
Reduce transport of sperm
Suppression of ovulation

Materials and Equipment Standards for

Insertion Implant

Insertion Implant Procedure

Before making the incision, make sure the effects of
anesthesia and pain sensation has gone missing.
1. Hold the scalpel with an angle of 45 , make a shallow
incision just to simply penetrate the skin. Do not make
a long and deeply incision.
2. Remember usability 2 mark on the trocar. Trocar must
be held by the end of the sharp facing up.There are
two marks on the trocar, the sign (1) near the base
shows the limits trocar is inserted down the skin
before inserting each capsule. Signs (2) near the end
of the show trocar limit should remain under the skin
after put each capsule.

3. With the trocar where the position

number
(Implant-2)
and
arrows
(Implant-2 Plus) facing up insert the tip
of the trocar incision to position 45
(when entering trocar tip) then lower to
30 when entering the subdermal layer
and parallel skin surface while pushing
up the sign 1 (3-5 mm from the base of
the trocar).

4. To put the capsules just under the skin, lift up

the trocar, so lifted skin. Enter the trocar slowly
and carefully in the direction of the mark (1)
near the base. Trocar should be shallow enough
so that it can be felt from the outside with a
finger. Trocar must always look to lift the skin
during installation. The entry of trocar will be
smooth if located just below the skin.
5. When the trocar entry up to the mark (1),
remove the plunger from the trocar (Implant2). To Implant-2 Plus, it plunger is inserted
(arrow next to the top position) after the sign
1 is reached and rotated 180 clockwise until
free from custody due to end driver enters the
capsule groove is in line trocar.

6. Insert the first capsule into the trocar. Use your

thumb and forefinger or tweezers or clamps to
take the capsule and insert into the trocar.
When the capsule is taken by hand, make sure
the gloves are free of talc or other particles. (In
Order To prevent falls at a time capsule inserted
into the trocar, put one hand on capsule bottom
to catch when the capsule crashed). This step is
not
performed on Implant-2 Plus because the
capsule is already in the trocar.

Push

capsule up entirely into the trocar

and reinsert the pushing.

7. Use the plunger to push the capsule towards the

end of the trocar until it no prisoners, but do not
push it by force (it will feel prisoner at the time
around half of the plunger into the trocar). To
Implant-2 Plus, after pushing insertion of capsule
lane then push the capsule until it feels prisoner.
8. Hold the plunger in place and then pull the trocar
using the finger and point finger in the direction of
the incision or close to the base of the plunger up
to the mark 2 appears. The incision and roots
touch the handle pusher. It is important in this
step is to keep the pusher firmly in place and do
not push the capsule to the tissue. To Implant-2
Plus, the base trocar will not reach the base of the
plunger because it will be stuck amid hindered by
the end of the plunger who have not gained
access to the second capsule.

9. At the base of the trocar to touch the handle pushing,

signs (2) should be seen in the edge of the incision and
the time capsule out of the trocar directly beneath the
skin. Feel the tip of the capsule with a finger to make
sure the capsule was out entirely from the trocar.
Note: Sharpening repeated trocar will make short trocar
distance to the mark (2). Therefore, when using the
trocar sharpened, do not pull trocar too far back, as it
will come out from the edge of the incision. The
important thing is the capsule free of trocar tip to avoid
cut of capsule when trocar actuated to put the next
capsule.

10. Without removing the entire trocar, turn

the tip of the trocar into the right lateral
direction and return it back to its
original position to ensure free first
capsule.

The

next insertion of implant, the trocar about

30 , following the pattern of the letter V on
the arm. To do that, first fixation with the first
capsule and reinsert the point finger slowly
trocar along the side of the poin finger up to
the mark (1). This is to ensure proper spacing
between the capsule and prevent trocar
piercing capsules previously installed.if that
has reach, insertion the next capsule in trokar
and do like before so all capsule inserted.

11. In inserted capsule after, for reduce risk of infection

or ekspulsion, make the end of capsule beside that
about 5 mm from side insision.
12. Before pull out trokar, palpation the capsule for
insure the capsule fixed.
13. End of two capsule must be apart from incision
wound
14. After the capsule fixed and position of a capsule
have sure right and remove trocar be slowly. Press
incision placed with the finger using cassa as long as
1 minute to stop bleeding. Clean inserted place with
antiseptic.

Discover

the incision edges and use a

band aid or plaster with sterile gauze
toclosing the incision. The incision does
not need stitches because it can cause
tissue
grated.
Check for bleeding. Cover the area with a
bandage for installation hemostasis and
reduce bruising (subcutaneous bleeding).

Materials and Equipment Standards for Removal Implant

Removal Implant
Standard Method
1. Determine the location of incisions that have the
same distance from the lower end of all
capsules (elbow), approximately 5 mm from the
lower end of the capsule. When the distance is
the incision is made at the same incision
installation time. Before determining the
location,
make sure there is no end of the capsule under
the
old
incision
(this
is
to
prevent
terpotongnya the time capsule incision).

2. At the selected location, create a

transverse incision (transverse) small
approximately 4 mm by using a scalpel.
Do not make a large incision.

STEP

3. Start by unplugging the capsule

easily felt from the outside or the nearest
the incision.
Push the end of the capsule in the
direction of the incision with your fingers
until the end of the capsule looked at the
incision. When the end of the capsule look
at the incision, insert the curved clamp
(mosquito or Crile) with tongs arch leads
to the top, then flip the tip
capsule with the clamp.

STEP

4. Insert the curved clamp through

the incision with arch tongs leads to the
skin, continue to be under the tip of the
capsule. Pinch capsule, pull out and clean
the tip of the capsule of connective tissue
that surrounds them.

STEP

5. Freeing the capsule of connective

tissue that surrounds them can be done
with the rubbing sterile gauze to expose
the tip of the capsule. Make sure the ends
of the capsule free from the network
belt so that it can be attached with
tweezers or pean.

STEP

6. Pinch the capsules are free from

connective tissue using a clamp pean
or anatomical tweezers while loosening the
clamp tongs first on the trunk second
capsuleand The capsule will be easily revoked
because the connective tissue that surrounds
it is not attached to the silicone rubber. When
the capsule is difficult revoked, separate
Carefully rest connective tissue attached to
the capsule using a gauze or scalpel.

STEP

7. Select the next capsule that looks

most easily removed. Use techniques
The same (STEP 4 to 6) to revoke the next
capsule.
Remember:
If
you
require
additional anesthetic, injected under the
capsule so that the capsule remains palpable
from the outside. Indicate the second
capsule on the client. It is very important to
reassure clients (if the client wants to
continue the use of implants-2).

STEP

8. Place the capsule that was repealed in

bowl. Repeat steps previous steps to revoke the
second capsule.
Remember: If you require additional anesthetic,
injected under the capsule so that the capsule
remains palpable from the outside
Make sure both the capsule has been removed.
Indicate the two capsules on the client that
time capsule has been revoked and a new
capsule will be fixed if the client wants it.