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 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 Outcome of patients undergoing amputation for diabetic foot ulcer

2018 ◽  
Vol 6 (1) ◽  
pp. 88
Author(s):  
Ashokkumar D. ◽  
Vinothkumar S. ◽  
Heber Anandan
Keyword(s):  
Lower Limb ◽  
Diabetic Foot ◽  
Care Center ◽  
Tertiary Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Ulcer ◽  
Delay In Diagnosis

Background: Foot ulcers are the principal cause of severe complications and hospitalization among patients with diabetes, substantially increasing the costs with this disease. Peripheral neuropathy, ulceration, infection, and peripheral vascular disease are the principal factors for ulcer complications and loss of a lower limb in diabetic patients. The aim of the present endeavor was to study the patients undergoing amputation for the diabetic foot ulcer.Methods: Total 150 patients with diabetic foot ulcer were included in this study. The variables investigated were related to diabetes, infection, and surgical treatment. In our series amputation were done at different levels anatomical levels ranging from toe level ranging from toe level to above knee amputation.Results: Pus culture and sensitivity done for diabetic foot ulcers reveal E. coil as the most common organism (40%). Skin biopsy done in these patients reveal neuropathic changes in 102 patients. 40% of patients had vaso-occlusive disease. Nine out of 150 patients showed osteomyelitis changes emphasizing those diabetic ulcer patients are prone for osteomyelitis of the underlying bone. 46% of patients with diabetic foot ulcer needed either minor or major amputation, which correlates with the standard study.Conclusions: Lack of awareness about diabetes mellitus and its lower limb complications, poor compliance to the treatment, poorly controlled blood sugar levels, delay in diagnosis, and late presentation to the tertiary care center are all factors which led to the occurrence of diabetic foot ulcer.

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 Genome sequencing and analysis of the first spontaneous Nanosilver resistant bacterium Proteus mirabilis strain SCDR1

2016 ◽  
Author(s):  
Amr T. M. Saeb ◽  
Khalid A. Al-Rubeaan ◽  
Mohamed Abouelhoda ◽  
Manojkumar Selvaraju ◽  
Hamsa T. Tayeb
Keyword(s):  
Ulcer Patient ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Resistant Isolate ◽  
Diabetic Ulcer ◽  
Indwelling Catheters ◽  
Silver Colloids ◽  
Nano Silver ◽  
Successful Infection ◽  
Resistant Bacterial Strain

AbstractBackgroundP. mirabilis is a common uropathogenic bacterium that can cause major complications in patients with long-standing indwelling catheters or patients with urinary tract anomalies. In addition, P. mirabilis is a common cause of chronic osteomyelitis in Diabetic foot ulcer (DFU) patients. We isolated P. mirabilis SCDR1 from a Diabetic ulcer patient. We examined P. mirabilis SCDR1 levels of resistance against Nano-silver colloids, the commercial Nano-silver and silver containing bandages and commonly used antibiotics. We utilized next generation sequencing techniques (NGS), bioinformatics, phylogenetic analysis and pathogenomics in the characterization of the infectious pathogen.ResultsP. mirabilis SCDR1 is a multi-drug resistant isolate that also showed high levels of resistance against Nano-silver colloids, Nano-silver chitosan composite and the commercially available Nano-silver and silver bandages. The P. mirabilis -SCDR1 genome size is 3,815,621 bp. with G+C content of 38.44%. P. mirabilis-SCDR1 genome contains a total of 3,533 genes, 3,414 coding DNA sequence genes, 11, 10, 18 rRNAs (5S, 16S, and 23S), and 76 tRNAs. Our isolate contains all the required pathogenicity and virulence factors to establish a successful infection. P. mirabilis SCDR1 isolate is a potential virulent pathogen that despite its original isolation site, wound, it can establish kidney infection and its associated complications. P. mirabilis SCDR1 contains several mechanisms for antibiotics and metals resistance including, biofilm formation, swarming mobility, efflux systems, and enzymatic detoxification.ConclusionP. mirabilis SCDR1 is the first reported spontaneous Nanosilver resistant bacterial strain. P. mirabilis SCDR1 possesses several mechanisms that may lead to the observed Nanosilver resistance.

Empirical Antibiotic Treatment in Diabetic Foot Infection: A Study Focusing on the Culture and Antibiotic Sensitivity in a Population From Southern China

2017 ◽  
Vol 16 (3) ◽  
pp. 173-182 ◽  
Author(s):  
Wen-xia Wu ◽  
Dan Liu ◽  
Yi-wen Wang ◽  
Chuan Wang ◽  
Chuan Yang ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Diabetic Foot ◽  
Southern China ◽  
Foot Ulcer ◽  
Antibiotic Sensitivity ◽  
Diabetic Foot Ulcer ◽  
Severe Infection ◽  
Third Generation ◽  
Diabetic Ulcer ◽  
Significant Difference

Diabetic foot and subsequent diabetic ulcer infections are the most devastating complication of diabetes. This study was conducted to explore the bacterial spectrum, sensitivity of microbials, and analysis of the empirical antibiotic regimens in our health center. The study included patients with diabetic foot ulcer infection (DFI) seen from 2009 to 2014. The patients included had all information covering the physical examination, laboratory tests, and image examinations. We sent appropriately obtained specimens for culture prior to starting empirical antibiotic therapy in all participants. A total of 312 patients were included: 52, 112, 95 and 53 patients within uninfected, mild, moderate, and severe infection groups. The total percentages of Gram-positive cocci (GPCs) and Gram-negative rods (GNRs) were 54% and 48.8% ( P = 0.63). The most common GPC was Staphylococcus aureus (22.4%) and GNR was Pseudomonas aeruginosa (11.9%). Methicillin-resistant Staphylococcus aureus was isolated from 21 patients (6.7%). Even in the mild infection group, there was no significant difference between GPC and GNR infection, irrespective of recent antibiotic use ( P = 0.053). The most frequently used empirical antibiotics in our center were second-/third-generation cephalosporin ± clindamycin, both in the mild and moderate/severe infection groups. In our center, the amoxicillin/clavulanate or ampicillin/sulbactam (β-L-ase 1) and second-/third-generation cephalosporins were highly resistant to the common GNR (30%-60%). The ticarcillin/clavulanate, piperacillin/tazuobactam (β-L-ase 2), fluoroquinolone, and group 2 carbapenem had good sensitivity. This study presents a comprehensive microbiological survey of diabetic foot ulcers in inpatients and provides reliable evidence of the local microbial epidemiology and sensitivity of antibiotics, which may help us improve clinical outcomes in DFI patients.

scholarly journals A Rare Form of Melanoma Masquerading as a Diabetic Foot Ulcer: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Susan Thomas ◽  
Yuan-Xiang Meng ◽  
Vijaykumar G. Patel ◽  
Gregory Strayhorn
Keyword(s):  
Case Report ◽  
Diabetic Foot ◽  
Primary Care Clinic ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Patients ◽  
Care Clinic ◽  
Acral Lentiginous Melanoma ◽  
Diabetic Ulcer ◽  
Formidable Challenge

Background. Acral lentiginous melanoma (ALM) is a less-common form of melanoma in US, and it accounts for about 5% of all diagnosed melanomas in US. ALM is often overlooked until it is well advanced because of the lesion’s location and its atypical appearance in the early stages. We present a case of ALM initially presented as a diabetic foot ulcer.Case Report. An 81-year-old man initially presented to the primary care clinic with a right foot diabetic ulcer. There was a large plantar, dark-colored ulcer that bled easy. Initial excision biopsy revealed Clark’s Level IV ALM. Subsequent definitive wide excision and sentinel node biopsy confirmed ALM with metastasis to inguinal lymph nodes (stage IIIb). The treatment included wide margin excision of the lesion with en bloc amputations of 4th and 5th toes, followed by adjuvant chemotherapy.Discussion. The development of ALM may potentially relate to diabetes as a reported higher prevalence of diabetes with ALM patients.Conclusion. The difficulty in early diagnosing of ALM remains as a formidable challenge particularly in diabetic patients who commonly develop plantar foot ulcers due to the diabetic neuropathy. This case reiterates the importance of a thorough foot exam in such patients.

scholarly journals Staged salvage of diabetic foot with Chopart amputation and intramedullary nailing

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110467
Author(s):  
Alexandre Leme Godoy-Santos ◽  
Fábio Correa Fonseca ◽  
Cesar de Cesar-Netto ◽  
Katrina Bang ◽  
Eduardo Araujo Pires ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Weight Bearing ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Gait Pattern ◽  
Distal Stump ◽  
Diabetic Ulcer ◽  
Pressure Therapy ◽  
Diabetic Foot Infections ◽  
Amputation Stump

We present a stepwise surgical approach that can be used, in lieu of a transtibial amputation, to preserve the lower limb in the setting of severe diabetic foot infections. A 63-year-old male status post left midfoot (Lisfranc’s) amputation presented to our hospital with a 4-year history of a left foot diabetic ulcer with associated purulent drainage and intermittent chills. On initial exam, the patient’s left foot amputation stump was plantarflexed, grossly erythematous, and edematous. The associated diabetic foot ulcer was actively draining purulent fluid. Following workup with radiography and ultrasound, the patient was diagnosed with a post-operative infection of the midfoot at the level of the amputation stump secondary to diabetic neuropathy. Our approach to management was a staged and included (1) surgical irrigation and debridement of the distal stump wound, (2) provisional negative pressure therapy, (3) a second-look procedure, and (4) a tibiotalocalcaneal fusion was performed using a lateral transfibular and plantar approach, after wound closure and resolution of active infection was achieved. At 36-month follow-up, the patient was fully weight-bearing in stiff sole sneakers with no gross overt alteration of gait pattern. The patient scored 79 points when assessed by the hindfoot American Orthopaedic Foot and Ankle Society Ankle-Hindfoot outcome score. In the patient with diabetes and cardiological restrictions, a Chopart amputation is preferred due to the decreased level of energy expenditure required for ambulation as compared to over more proximal levels of amputation.

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.

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