scholarly journals Health service for diabetic foot ulcer patients during covid-19 pandemic

2021 ◽  
Vol 4 (4) ◽  
pp. 311
Author(s):  
Hermawati Hermawati ◽  
Yulius Tiranda ◽  
Sukron Sukron
Keyword(s):  
Health Service ◽  
Health Services ◽  
Diabetic Foot ◽  
Wound Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Service Needs ◽  
Online Consultation ◽  
Risk Of Exposure ◽  
Hospital Visits

In early 2020, the whole world was shocked by the COVID-19 pandemic, which impacted all aspects of life. One was changes in the service system and health care for patients with diabetic foot ulcers (DFU). Wound care in DFU patients should be routine but while minimizing hospital visits to reduce the risk of exposure to COVID-19. The objective of this study was to explore the health services provided to DFU patients during the COVID-19 pandemic at the hospital. This study used a literature review approach with six electronic databases, namely National Library, PubMed, Science Direct, ProQuest, Springer Nature, and Wiley, in 2019-2021. The keyword used were health service, diabetic foot ulcer and COVID-19. around 669 articles identified, 12 articles met the inclusion. The articles reviewed were obtained from the result of discussion and validations between researcher and supervisors following the Prisma Guideline. Health services for DFU patients during the COVID-19 pandemic may be conducted through several stages including a) online consultation or telemedicine as the first stage, b) continued with triage process, and c) screening for individual patients needs. Health services for DFU patients during the COVID-19 pandemic have changed according to the following conditions. The first procedure was to conduct an online consultation (telemedicine) to assess the client’s condition related to complaints, then proceed with the triage process to prioritize care and service needs. The health of each patient and screening to check for symptoms of COVID-19 as well as carried out additional screening, CT Thorax and Swab if the patient had to go to the hospital.

scholarly journals THE RELATIONSHIP OF THE INITIAL WOUND WITH THE WOUNDS LONG TREATMENT IN DIABETICUM PATIENTS AT CIBINONG HOSPITAL BOGOR

2020 ◽  
Vol 11 (2) ◽  
pp. 35-40
Author(s):  
Ranti Ranti
Keyword(s):  
General Hospital ◽  
Diabetic Foot ◽  
Wound Care ◽  
Day Treatment ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Stage I ◽  
Stage Iii ◽  
P Value ◽  
Early Wound

According to the survey data of American Diabetes Association (ADA) in 2014, the global prevalence rate of DM patients in 2014 was 8,3% out of total population of the world, and it has increased to 387 cases in 2014. Sulistyowati, D. A. stated that in 2015 for the prevalence of the patients suffering from diabetic foot ulcer was 15% with the risk of amputation of 30%, mortality rate of 32%, and in Indonesia, diabetic foot ulcer is the disease whose probability to be hospitalized is 80%. This research aims at finding out the relation between the early wound stage and the length of wound care towards the patients of ulcus diabeticum at Cibinong General hospital in 2018. This study is a quantitative analytic research with the approach of cross sectional. The population of this research is 40 respondents, and the research sample is 40 respondents by taking the technique of Total Sampling. The data collection is derived from the observation sheet. Based on the research findings, it is known that 14 respondents (77.8%) who suffered from the stage I-II wound needed 3-5 day treatment. Moreover, 19 respondents (86,4%) who suffered from stage III-IV wound needed 6-8 day treatment. The result of statistical test by taking cremer von mises test derived the value p=0,000 meaning that p value <0,05 signifies Ha received. This indicates that there is a significant relation between the early wound stage and the length of wound care towards the patients of ulcus diabeticum. Result analysis also obtains the value OR of 22.167 meaning that the wound stage III-IV will have the possibility of influencing the length of wound care of 22.167 times compared to the stage I-II. There is a relation between the early wound stage and the length of wound care towards the patients of ulcus diabeticum at Cibinong General Hospital. This research finding is expected to be a recommendation for the patients suffering from ulcus diabeticum, particularly those who suffer from stage III-IV with a long wound care.

scholarly journals A randomized controlled trial of the safety and efficacy of a topical gentamicin–collagen sponge in diabetic patients with a mild foot ulcer infection

2018 ◽  
Vol 6 ◽  
pp. 205031211877395 ◽  
Author(s):  
Ilker Uçkay ◽  
Benjamin Kressmann ◽  
Sébastien Di Tommaso ◽  
Marina Portela ◽  
Heba Alwan ◽  
...  
Keyword(s):  
Antimicrobial Therapy ◽  
Diabetic Foot ◽  
Wound Care ◽  
Controlled Trial ◽  
Pilot Trial ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Collagen Sponge ◽  
Diabetic Patients ◽  
Topical Antibiotic

Objectives: The initial phase of infection of a foot ulcer in a person with diabetes is often categorized as mild. Clinicians usually treat these infections with antimicrobial therapy, often applied topically. Some experts, however, believe that mild diabetic foot ulcer infections will usually heal with local wound care alone, without antimicrobial therapy or dressings. Methods: To evaluate the potential benefit of treatment with a topical antibiotic, we performed a single-center, investigator-blinded pilot study, randomizing (1:1) adult patients with a mild diabetic foot ulcer infection to treatment with a gentamicin–collagen sponge with local care versus local care alone. Systemic antibiotic agents were prohibited. Results: We enrolled a total of 22 patients, 11 in the gentamicin–collagen sponge arm and 11 in the control arm. Overall, at end of therapy, 20 (91%) patients were categorized as achieving clinical cure of infection, and 2 (9%) as significant improvement. At the final study visit, only 12 (56%) of all patients achieved microbiological eradication of all pathogens. There was no difference in either clinical or microbiological outcomes in those who did or did not receive the gentamicin–collagen sponge, which was very well tolerated. Conclusion: The results of this pilot trial suggest that topical antibiotic therapy with gentamicin–collagen sponge, although very well tolerated, does not appear to improve outcomes in mild diabetic foot ulcer infection.

Management of Diabetic Foot Ulcer by Nishadi Yoga Avachoornana - A Case Study

2017 ◽  
Vol 2 (06) ◽  
Author(s):  
Chiranth Kumar R. ◽  
Syeda Ather Fathima
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Life Style ◽  
Genetic Factor ◽  
Wound Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Foot Complications ◽  
Scientific Approach

Diabetes is considered as ‘ice burg’ of diseases as only 1/3rd of its manifestations can be made out clinically, though the exact cause is not known following are the theories put forth to explain diabetes mellitus - Genetic factor, Life style disorder, Autoimmune cause. Slight injury to glucose laden tissue will cause infection which is precipitated by an ulcer and it tends to a state of non - healing. Main stay of treatment includes antibiotics, debridement, local wound care. Inspite of these treatments there is less reduction in the statistics of diabetic foot complications and amputations. In Sushrutha Samhitha we get the most scientific approach for the management of Vrana, where Sushrutha has mentioned 60 Upakrama’s (modalities of treatment) of which Avachoornana (dusting) is one modality, seen to be effective in the management of diabetic non healing ulcers (Madhu Mehaja Dusta Vrana).

scholarly journals STRESS PASIEN DENGAN ULKUS KAKI DIABETIKUM DI AL HIJRAH WOUND CARE CENTER JOMBANG

2020 ◽  
Vol 6 (1) ◽  
pp. 128-136
Author(s):  
Fahruddin Kurdi ◽  
Anja Hesnia Kholis ◽  
Nurul Hidayah ◽  
Maya Fitriasari
Keyword(s):  
Diabetic Foot ◽  
Nuclear Family ◽  
Wound Care ◽  
Ulcer Patient ◽  
Care Center ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Ulcer ◽  
Psychological Burden ◽  
Diabetic Ulcers

ABSTRACT Diabetic foot ulcer is a complication of mellitus. The complication can cause psychological problems that cause stress for patient. The severity of diabetic foot ulcer will increase stress in patients. To deal with stress that needs to be overcome by reducing stress independently, besides the support system of the family is needed to help reduce stress and psychological burden. The purpose of this research is to explore how stress is experienced by diabetic foot ulcer patient.                 This research is a qualitative research with phenomenology approach. Participants were diabetic ulcer who come for wound care treatments at Al Hijrah wound care center, as well as the nuclear family as additional informants. Data is taken with a thorough interview, observation.                 The results obtained from two participants that stress due to diabetic ulcers is a condition related to physical and psychological conditions that cause participants to increase stress, such as: body image disorders, immobility, fear to amputation and cost difficulties.                 The main effort to reduce stress is pray, read the Al Quran, dzikr and ask for help to health services in the hope that the stress can reduced independently and does not cause worse complications. It is hoped that further research will examine more deeply the stress experienced by patients with diabetic ulcers.  

scholarly journals Autolytic and Conservative Sharp Wound Debridement for Granulation Tissue on Unstageable Diabetic Foot Ulcer

2018 ◽  
Vol 1 (1) ◽  
pp. 80-87
Author(s):  
Ratna Aryani (Corresponding author) ◽  
Uun Nurulhuda
Keyword(s):  
Diabetic Foot ◽  
Wound Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
T Test ◽  
Mean Difference ◽  
Group Method ◽  
P Value ◽  
Care Clinic ◽  
Wound Debridement

Diabetic foot ulcer (DFU) is a condition of deep tissue damage associated with Diabetes Mellitus in the lower extremities. Conducted with quantitative research of single group method with pre and post test design approach, this research primarily aims to know the effectiveness of utilizing combination of Autolysis & Conservative Sharp Wound Debridement in preparing granulation on unstageable DFU. It involved 30 respondents in the wound care clinic as the research sample and used the Wound Bed Score observation sheets measured on days 1, 7 and 28. The data analysis to determine effectiveness before and after intervention was carried out using dependent t-test (paired t-test), whilst to test effectiveness of giving intervention after controlled confounder was performed by linear regression. Based on the characteristics of the respondent’s, it is revealed that most of them were female (83.3%) and have normal BMI (80%). The average age of the respondents were 55.43 years old with the duration of DM of 13.27 years with average blood sugar of 101.2 mg/dL. The highest mean difference was on the 1st day of the 28th. The statistical results of this study indicated that the mean difference values for day 1 and 7 were 0.133 (SD 1.19, p value = 0.546), mean difference of day 7 and day 28th grade was of 2.5 (SD 1.306, p value=0.0001) and mean difference between day 1 and day 28 was of 2.63 (SD 1.273, p value=0.0001). This research recommends that the further research use different research methods.

scholarly journals KEJADIAN DERAJAT LUKA DIABETES TIDAK BERHUBUNGAN DENGAN NILAI RISIKO DIABETIC FOOT ULCER

2017 ◽  
Vol 4 (2) ◽  
pp. 215-227
Author(s):  
Risma Anggraeni Yuliastuti ◽  
Megah Andriany ◽  
Eka Putri Y.
Keyword(s):  
Diabetic Foot ◽  
Wound Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Risk Level ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Diabetic Ulcer ◽  
Significance Level ◽  
Risk Levels

The highest diabetic complication percentage is neuropathy (54%) causing diabetic foot ulcer (DFU). The study aimed to know the relationship between diabetic foot ulcer risk levels with diabetic ulcer severity levels. Scope of the study was diabetic wound care, particularly on legs mostly experienced by diabetic patients. The method used was descriptive correlation with cross sectional design. Sampling method was non probability with purposive sampling. Respondent number was 16 persons with inclusion criteria was diabetic patients with ulcer in one leg and no ulcer on another side in the second visitation to a diabetic clinic in Bekasi,Indonesia and agreed to be involved in the study. DFU risk level instrument modified from Diabetes Foot Screening and Risk Stratification Form of New Zealand Society for Study of Diabetes (NZSSD) to measure the DFU degree on legs with no ulcer. Another tool was to measure severity level of legs with ulcer according to Wagner. Data analysis used Kendall’s tau with 0.05 of significance level. The result shows there is no relationship between DFU risk levels with severity degree of diabetic ulcers. From the study, we can conclude that nurses do not need provide specific DFU prevention based on diabetic ulcer severity grade. 

scholarly journals Kemudahan Penggunaan Alat Bantu Simple Foot Elevator (SFE) dalam Perawatan Luka Kaki Diabetes

2019 ◽  
Vol 12 (2) ◽  
Author(s):  
Nuh Huda ◽  
Dini Mei Widayanti
Keyword(s):  
Diabetic Foot ◽  
Wound Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Lower Limbs ◽  
Diabetic Ulcer ◽  
Significance Level ◽  
Number Of Patients ◽  
Post Test ◽  
Quasi Experimental

Increasing the number of patients with DM, complications are also increasing, one of them is ulceration of the lower limbs, with or without infection and cause damage to the underlying tissue, hereinafter referred to as diabetic foot (KD) or diabetic foot wound. In the world, the number of diabetic foot patients is expected to continue to rise. Diabetic wound care also creates difficulties for the nurse. The purpose of this study is to analyze the level of ease of simple foot elevator (SFE) tools in the treatment of diabetic wounds. This type of research is quasi experimental Pre and Post Test Without Control Design by creating a prototype called SFE. This tool was then tested on 12 diabetic patient nurses with diabetic ulcer complications in the lower extremity area. The variable of this study is to measure the degree of ease of nurses in performing the treatment of Diabetic Injuries through the questionnaire. Data processing research with Mann Withney test with significance level (α = 0,05) or CI = 95%. The result of statistical test by using Mann-Whitney test is 0.014, the result p is less than α, meaning that statistically shows that the use of SFE (Simple Foot Elevator) tool is easy to be used by nurses when performing diabetic foot ulcer treatment in Room 3 Rumkital Dr. Ramelan Surabaya. The use of SFE is easy to use. So it can be recommended as one alternative tool that can be used in wound care.Keyword : Diabetes Mellitus, Diabetic Foot Wounds, SFE

scholarly journals Efek Terapi Adjuvan Extracorporal Shockwave terhadap Penyembuhan Ulkus Kaki Diabetik Penyandang Diabetes Melitus Tipe 2 dengan Penanda Vascular Endothelial Growth Factor

e-CliniC ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 509
Author(s):  
Harris J. Tampubolon ◽  
Adrian Tangkilisan ◽  
Wega Sukanto ◽  
Grace E. C. Korompips
Keyword(s):  
Diabetic Foot ◽  
Wound Care ◽  
Pearson Correlation ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Extracorporeal Shock Wave Therapy ◽  
Repeated Measurements ◽  
Control Group ◽  
Extracorporeal Shock Wave ◽  
Vegf Level

Abstract: Diabetic foot ulcer (DFU) prevalence tends to increase every year. Within 30 seconds it is predicted that one leg will be amputated due to DFU. New blood formation triggered by adjuvant extracorporeal shock wave therapy (ESWT) on increasing VEGF level is expected to promote DFU healing. This study was aimed to prove whether ESWT as an adjuvant therapy could stimulate DFU healing by increasing VEGF serum level. This was a quasi-experimental study using two groups, the ESWT and the control groups. Two repeated measurements of VEGF levels and PEDIS scores were performed. The ESWT group (17 patients) received the adjuvant ESWT and the control group (7 patients) received conventional wound care therapy. Both groups received 8-time treatment for 4 weeks. Measurements of VEGF levels and PEDIS scores were performed at baseline and after 4 weeks. The results showed that the PEDIS score of the ESWT group decreased, albeit, not in the control group. The VEGF level of the ESWT group significantly increased (mean rank=13.24) compared to the control group (mean rank=7.33). The Wilcoxon signed-ranks test indicated that the PEDIS score in ESWT group had a significant decrease compared to the control group (mean rank=7.50), Z=-3.372, p=<.001. The Pearson correlation test showed a significant relationship between VEGF value and the PEDIS score reduction (81.4%).  In conclusion, the adjuvant ESWT therapy could promote DFU healing (reduced PEDIS score) and increase VEGF levels in DFU patients.Keywords: ESWT; VEGF; diabetic foot ulcer (DFU) Abstrak: Prevalensi ulkus kaki dibetik (UKD) terus meningkat setiap tahunnya dan dalam 30 detik diprediksi terdapat satu kaki yang diamputasi karena UKD. Pembentukan pembuluh darah baru yang dipicu oleh penggunaan adjuvan ESWT terhadap peningkatan kadar VEGF diharapkan dapat memper-cepat penyembuhan UKD. Penelitian ini bertujuan untuk membuktikan terapi adjuvan ESWT dapat meningkatkan kadar VEGF dalam penyembuhan UKD. Jenis penelitan ialah kuasi-eksperimental yang membandingkan dua kelompok perlakuan (ESWT vs kontrol) melalui dua pengukuran berulang terhadap kadar VEGF dan skor pedis. Kelompok ESWT (17 pasien) mendapatkan terapi adjuvan ESWT dan kelompok kontrol (7 pasien) mendapatkan terapi konvensional perawatan luka. Kedua kelompok mendapatkan perlakuan 2 kali per minggu selama 4 minggu. Pengukuran kadar VEGF dan skor pedis pada baseline dan setelah selesai 4 minggu perlakuan. Hasil penelitian mendapatkan penurunan skor PEDIS hanya pada kelompok ESWT (14 pasien), Kadar VEGF kelompok perlakuan didapatkan meningkat bermakna (mean rank=13,24) dibandingkan kelompok kontrol (mean rank=7,33) (p<0,001). Wilcoxon Signed-Ranks Test mengindikasikan bahwa nilai skor PEDIS kelompok ESWT mengalami penurunan bermakna dibandingkan kelompok kontrol (mean rank=7,0), Z=-3,372, p=<0,001. Uji korelasi Pearson menunjukkan hubungan bermakna antara perubahan nilai VEGF dengan skor pedis (81,4%). Simpulan penelitian ini ialah terapi adjuvan ESWT dapat memicu penyembuhan UKD (menurunkan skor PEDIS) dan meningkatkan kadar VEGF pada pasien UKDKata kunci: ESWT; VEGF; ulkus kaki diabetik (UKD)

Avoidance of lower limb amputation from a diabetic foot ulcer: The importance of multidisciplinary practice and patient collaboration

WCET Journal ◽  
2019 ◽  
Vol 39 (2) ◽  
pp. 19-27
Author(s):  
Margaret Mungai ◽  
Emmy Sirmah
Keyword(s):  
Lower Limb ◽  
Diabetic Foot ◽  
Wound Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Limb Amputation ◽  
Nursing Interventions ◽  
Multidisciplinary Practice ◽  
Sugar Levels ◽  
Care Nursing

This article explores wound care nursing interventions and inter-professional collaboration for a patient referred with a stage 3 diabetic foot ulcer (DFU). To the patient’s distress, he had been informed that he may require an amputation due to the severity of his DFUs. On initial presentation, the patient was symptomatic for peripheral neuropathy, infection and hyperglycaemia. The left lower limb was oedematous and there was a DFU at the metatarso-phalangeal joint of the big toe on his left foot secondary to haemorrhagic callus. Progressive healing of the DFU was realised over time by repetitive debridement; incision and drainage of the DFUs; antibiotic therapy; appropriate footwear; dietary instructions; control of the blood sugar levels (BSLs); and patient and family education. Wound care nursing interventions were applied in conjunction with medical management of the DFUs. The DFUs were managed using a locally made, two-part zinc oxide gauze dressing known as the Unna boot. A family member was instructed how to continue applying the dressings at home in between clinic visits. Complete wound healing was eventually achieved within four months, thus avoiding the need for amputation.

Jaloukavacharana in diabetic foot ulcer - A Case Study

2017 ◽  
Vol 2 (3) ◽  
Author(s):  
Nivedita Rampure ◽  
Channabasavanna B. M. ◽  
Mallikarjun Mallikarjun
Keyword(s):  
Lower Limb ◽  
Diabetic Foot ◽  
Wound Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Large Sample Size ◽  
Prolonged Stay ◽  
Bloodletting Therapy

Diabetic foot is the one of the commonest chronic complications of diabetes. It is leading indication for hospital admission and prolonged stay. A classical triad of neuropathy, ischemia and infection characterizes the diabetic foot. The presence of infection rapidly worsens the clinical picture, often requiring limb amputation. Diabetic foot ulcers are common and estimated to effect 15% of all diabetics. Mainstay of treatment includes antibiotics, debridement. and local wound care and footwear improvisation. In spite of all advances in health sciences, statistics reveals that about 3% patients yet have to undergo lower limb amputation. In Sushruta Samhita. we get the most scientific description of wound and its management. Similarly, Sushruta has given the importance to Bloodletting therapy and considered Leech as the most unique and effective method of bloodletting even in infected wounds and abscesses. Patient with Diabetic foot ulcer was advised to continue anti diabetic medicine along with weekly application of Leech around the ulcer which was followed by washing the wound with Panchavalkala Kashaya and dressing with Jatyadi Ghrita. This Leech therapy proved very effective and the ulcer healed completely within 30 days. However, further evaluation is required to be done by taking a large sample size to prove its significance in treating Diabetic foot ulcer and avoiding lower limb amputation.

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