IPSWICH TOUCH TEST SEBAGAI METODE SEDERHANA DALAM MENDETEKSI DIABETIC POLYNEUROPATHY (DPN) : LITERATURE REVIEW

ABSTRAK Penderita Diabetes Melitus (DM) memiliki potensi untuk menyebabkan banyak komplikasi baik yang dikelola dengan baik atau tidak dan banyak dari mereka tidak menyadari hal tersebut. Gangguan sensasi pada ekstermitas bawah, merupakan gejala awal komplikasi DM yang akan menjadi cikal bakal terjadinya Diabetic Foot Ulcer (DFU). Studi literature ini bertujuan untuk menampilkan hasil dari beberapa penelitian yang menggunakan IpTT dalam penelitian terhadap deteksi neuropati pada pasien DM. Metodologi yang digunakan untuk tinjauan ini adalah hasil telaah dari beberapa penelitian tentang ”Ipswich Touch Test” yang dipublikasi pada tiga data base. Kami mengkategorikan studi berdasarkan tipe DM, metode penelitian yang dilakukan adalah ah Randomize Controlled Trial dengan systematic review. Kami membandingkan kesimpulan penelitian berdasarakan tingkat sensibilitas klien diabetes pada daerah perifer/DPN dengan IpTT. Temuan kami menunjukkan bahwa IpTT merupakan salah satu metode yang reliabel, valid mudah, murah dan tidak menimbulkan bahaya serta dapat diajarkan kepada pasien dan keluarga dalam mendeteksi risiko Diabetic foot ulcer (DFU) pada penderita diabetes. IpTT juga memiliki nilai prediktif negatif yang tinggi dan keakuratan yang sangat baik bila dibandingkan dengan metode skrining standar mendukung perannya sebagai alat skrining untuk mendeteksi risiko DFU pada pasien diabetes. Kesimpulannya adalah IpTT merupakan salah satu metode untuk menilai tingkat sensibilitas pasien DM yang cukup sensitif, efektif, spesifik, mudah dilakukan tidak memerlukan biaya maupun alat serta tidak menimbulkan bahaya baik bagi pasien maupun pemeriksa dan dapat dilakukan oleh siapapun. Kata kunci: Ipswich Touch Test, neuropati, sensibilitas ABSTRACT People with diabetes mellitus (DM) have the potential to cause many complications no matter how well-managed and most of them are unaware. Impaired sensation in the lower extremity, is an early warning of DM complications that will become a Diabetic Foot Ulcer (DFU). The aim of this study is to present the results from several studies using IPTT in research neuropathy of DM patients detection. The methodology used for this review is the result of several studies on the "Ipswich Touch Test" published on three data bases. We categorize studies based on type of DM, the research method is Randomize Controlled Trial with a systematic review. We compared the study conclusions based on the level of diabetes client sensibility in the peripheral area/DPN with IpTT. Our finding show that IpTT is a reliable, easy, inexpensive and harmless method and it can be taught to the patients and families in detecting the risk of diabetic foot ulcer (DFU). IpTT also has a high negative predictive value and excellent accuracy when it compared to standard screening methods for supporting role as screening tool to detect the risk of DFU in diabetic patients. The conclusion is the IpTT as a method for assessing the level of DM patient sensibility is quite sensitive, effective, specific, easy to do, cost-free, without tools and harmless to both patients and examiners and it can be done simply by almost anyone. Kata Kunci: Ipswich Touch Test, neuropathy, sensibility

Download Full-text

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

SAGE Open Medicine ◽

10.1177/2050312118773950 ◽

2018 ◽

Vol 6 ◽

pp. 205031211877395 ◽

Cited By ~ 8

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.

Download Full-text

Prevalence of diabetic foot ulcer and its association with duration of illness and residence in Ethiopia: a systematic review and meta-analysis

10.1101/19003061 ◽

2019 ◽

Author(s):

Henok Mulugeta ◽

Fasil Wagnew ◽

Haymanot Zeleke ◽

Bekele Tesfaye ◽

Haile Amha ◽

...

Keyword(s):

Systematic Review ◽

Diabetic Foot ◽

Meta Analysis ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Foot Ulcers ◽

Diabetic Patients ◽

Diabetic Foot Ulcers ◽

Duration Of Illness ◽

National Prevalence

AbstractBackgroundDiabetic foot ulcer (DFU), devastating complications of diabetes mellitus, is a major public health problem, and one of the leading reasons for hospital admission, amputations, and even death among diabetic patients in Ethiopia. Despite its catastrophic health consequences, the national burden of diabetic foot ulcer remains unknown in Ethiopia. Hence, the objective of this systematic review and meta-analysis was to estimate the national prevalence of diabetic foot ulcer and investigate the association with duration of illness and patient residence among diabetic patients.MethodsWe searched PubMed, Google Scholar, Cochrane Library, CINAHL, EMBASE, and PsycINFO databases for studies of diabetic foot ulcers prevalence that published from conception up to June 30, 2019. Quality of each article was assessed using a modified version of the Newcastle-Ottawa Scale for cross-sectional studies. All statistical analyses were done using STATA version 14 software for Windows, and meta-analysis was carried out using a random-effects method. The pooled national prevalence of diabetic foot ulcers was presented using a forest plot.ResultsA total of 10 studies with 3,029 diabetic patients were included. The pooled national prevalence of diabetic foot ulcers among Ethiopian diabetic patients was 11.27% (95% CI 7.22, 15.31%, I2=94.6). Duration of illness (OR: 3.91, 95%CI 2.03, 7.52, I2=63.4%) and patients’ residence (OR: 3.40, 95%CI 2.09, 5.54, I2=0.0%) were significantly associated with a diabetic foot ulcer.ConclusionIn Ethiopia, at least one out of ten diabetic patients had diabetic foot ulcers. Healthcare policymakers (FMoH) need to improve the standard of diabetic care and should design effective preventive strategies to improve health care delivery for people with diabetes and reduce the risk of foot ulceration.

Download Full-text

Clinical, Pathological and Microbiological Evaluation of Diabetic Foot Syndrome

Medicina ◽

10.3390/medicina56080380 ◽

2020 ◽

Vol 56 (8) ◽

pp. 380

Author(s):

Bogdan Uivaraseanu ◽

Simona Bungau ◽

Delia Mirela Tit ◽

Ovidiu Fratila ◽

Marius Rus ◽

...

Keyword(s):

Diabetic Foot ◽

Treatment Options ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Diabetic Polyneuropathy ◽

High Rate ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Complications Of Diabetes ◽

Bacterial Aetiology

Background and objectives: Diabetic foot ulcer (DFU) is one of the serious complications of diabetes, being related to frequent and long-term hospitalisation, reduced quality of life of the patient, amputations, a high rate of morbidity and mortality. The bacterial aetiology is complex, sometimes involving more than one pathogen, playing a major role in the infection prognosis and development of microbial resistance. This study evaluated the current state of the aetiology, clinical and pathological characteristics of DFU in a single diabetes centre in order to provide some specific measures to prevent it. Materials and Methods: This retrospective study was conducted on patients with diabetes mellitus (252 individuals diagnosed with DFU) between January 2018–December 2019. All participants were assessed based on their clinical characteristics, including complications of diabetes and pathological and microbiological evaluations. Results: The present research revealed that diabetic foot ulcer prevalence was higher in males than in females and higher in type 2 diabetic patients than in type 1 diabetic patients. The patients with diabetic foot ulcer were older, had a higher body mass index (BMI), longer diabetic duration and had more diabetic complications, such as retinopathy, diabetic polyneuropathy and diabetic kidney disease, than patients without diabetic foot ulceration. Conclusions: Taking into account all factors involved, including the aetiology and the antibiotic susceptibility pattern of these isolates, planning the suitable treatment options of patients is possible.

Download Full-text

The Effects of Silver-Releasing Foam Dressings on Diabetic Foot Ulcer Healing

Journal of Clinical Medicine ◽

10.3390/jcm10071495 ◽

2021 ◽

Vol 10 (7) ◽

pp. 1495

Author(s):

Yu-Chi Wang ◽

Hsiao-Chen Lee ◽

Chien-Lin Chen ◽

Ming-Chun Kuo ◽

Savitha Ramachandran ◽

...

Keyword(s):

Wound Healing ◽

Diabetic Foot ◽

Healing Rate ◽

Early Period ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Wound Management ◽

Control Group ◽

Diabetic Patients ◽

High Morbidity

Diabetic foot ulcers (DFUs) are a serious complication in diabetic patients and lead to high morbidity and mortality. Numerous dressings have been developed to facilitate wound healing of DFUs. This study investigated the wound healing efficacy of silver-releasing foam dressings versus silver-containing cream in managing outpatients with DFUs. Sixty patients with Wagner Grade 1 to 2 DFUs were recruited. The treatment group received silver-releasing foam dressing (Biatain® Ag Non-Adhesive Foam dressing; Coloplast, Humlebaek, Denmark). The control group received 1% silver sulfadiazine (SSD) cream. The ulcer area in the silver foam group was significantly reduced compared with that in the SSD group after four weeks of treatment (silver foam group: 76.43 ± 7.41%, SSD group: 27.00 ± 4.95%, p < 0.001). The weekly wound healing rate in the silver foam group was superior to the SSD group during the first three weeks of treatment (p < 0.05). The silver-releasing foam dressing is more effective than SSD in promoting wound healing of DFUs. The effect is more pronounced in the initial three weeks of the treatment. Thus, silver-releasing foam could be an effective wound dressing for DFUs, mainly in the early period of wound management.

Download Full-text

Beraprost Sodium for Chronic Diabetic Foot Ulcer: A Randomized Controlled Trial in Thammasat University Hospital

Annals of Vascular Diseases ◽

10.3400/avd.oa.13-00092 ◽

2014 ◽

Vol 7 (1) ◽

pp. 40-45 ◽

Cited By ~ 1

Author(s):

Surajit Awsakulsutthi ◽

Kwanjit Punpho ◽

Jinpitcha Mamom ◽

Pairat Baikrut ◽

Patcharee Yingchoorod

Keyword(s):

Randomized Controlled Trial ◽

Diabetic Foot ◽

Controlled Trial ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

University Hospital ◽

Randomized Controlled ◽

Beraprost Sodium

Download Full-text

Efek Terapi Oksigen Hiperbarik (TOHB) pada Penyembuhan Ulkus Kaki DM Tipe 2 Berdasarkan Skor PEDIS

JURNAL BIOMEDIK (JBM) ◽

10.35790/jbm.11.2.2019.23323 ◽

2019 ◽

Vol 11 (2) ◽

pp. 110

Author(s):

Ekanova R. N. Sumarauw ◽

Mendy J. Hatibie ◽

Djony E. Tjandra ◽

Fredrik G. Langi

Keyword(s):

Wound Healing ◽

Diabetic Foot ◽

Controlled Trial ◽

Healing Process ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Control Group ◽

Wound Healing Process ◽

Holistic Treatment ◽

The Third

Abstract: Diabetic foot ulcer (DFU) is still a health problem related to the extent amount of time in wound healing process hence increasing the treatment cost. Given any methods that are not sat-isfying, encourage the search of other methods that would increase the wound healing rate, in which hyperbaric oxygen therapy (HBOT) is amongst them. The DFU patient that receives HBOT shows a significant increase in angiogenesis process markedly by faster epithelialization and granulation process. This study was aimed to prove that HBOT could accelerate the wound healing process among DFU patients measured by wound size and depth of PEDIS score. This was a ran-domized controlled trial study, conducted at Surgery Department of Prof. Dr. R. D. Kandou Gen-eral Hospital from September 2018 to March 2019. There were 20 DFU patients divided into two groups, each of 10 patients. The control group received a holistic treatment, meanwhile the HBOT group received a holistic treatment added with the inclusion of HBOT. PEDIS score assessment of DFU in HBOT group was measured before and after the third HBOT session, meanwhile the con-trol group was measured on the first and the third day. The results showed that the difference in PEDIS score value was markedly found in HBOT group compared to the control group (2 vs. 0, P=0.001). Conclusion: HBOT could enhance the wound healing process in DFU patients based on the declined PEDIS score.Keywords: HBOT, PEDIS score, diabetic foot ulcerAbstrak: Ulkus kaki diabetik (UKD) masih merupakan masalah kesehatan terkait proses penyembuhan lama sehingga biaya pengobatan meningkat. Belum adanya metode penanganan yang memuaskan, mendorong pencarian metode percepatan penyembuhan luka, salah satunya ialah terapi oksigen hiperbarik (TOHB). Penderita UKD yang menjalani tambahan TOHB diketahui mengalami peningkatan proses angiogenesis yang menghasilkan proses epitelialisasi dan granulasi yang lebih cepat. Tujuan penelitian ialah untuk membuktikan bahwa TOHB dapat mempercepat proses penyembuhan UKD, dinilai berdasarkan ukuran dan kedalaman luka melalui skor PEDIS. Penelitian ini menggunakan randomized controlled trial dan dilaksanakan di Bagian Bedah RSUP Prof. Dr. R.D. Kandou Manado sejak September 2018 sampai dengan Maret 2019. Subyek penelitian sebanyak 20 penderita UKD, dibagi dalam dua kelompok, masing-masing 10 penderita. Kelompok kontrol menjalani penanganan holistik UKD, sedangkan kelompok TOHB menjalani penanganan holistik UKD dengan TOHB. Penilaian skor PEDIS terhadap UKD pada kelompok TOHB dilakukan sebelum dan sesudah TOHB sesi ke-3, sedangkan pada kelompok kontrol dilakukan penilaian pada hari ke-1 dan hari ke-3 sesudahnya. Hasil penelitian mendapatkan bahwa perubahan skor PEDIS yang terjadi antara kedua pengukuran terlihat lebih besar pada kelompok TOHB dibandingkan kelompok kontrol (2 vs 0, P=0,001). Simpulan. TOHB mempercepat proses penyembuhan UKD dinilai dari penurunan skor PEDIS.Kata kunci: TOHB, skor PEDIS, ulkus kaki diabetik

Download Full-text

Prevalence of Diabetic Foot Ulcer and Associated Factors among Adult Diabetic Patients Who Attend the Diabetic Follow-Up Clinic at the University of Gondar Referral Hospital, North West Ethiopia, 2016: Institutional-Based Cross-Sectional Study

Journal of Diabetes Research ◽

10.1155/2017/2879249 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8 ◽

Cited By ~ 22

Author(s):

Tesfamichael G. Mariam ◽

Abebaw Alemayehu ◽

Eleni Tesfaye ◽

Worku Mequannt ◽

Kiber Temesgen ◽

...

Keyword(s):

Diabetes Mellitus ◽

Diabetic Foot ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Cross Sectional Study ◽

Care Practice ◽

Diabetic Patients ◽

Sectional Study ◽

Cross Sectional ◽

Factors Associated

Diabetes mellitus is a metabolic disorder which is characterized by multiple long-term complications that affect almost every system in the body. Foot ulcers are one of the main complications of diabetes mellitus. However, there is limited evidence on the occurrence of foot ulcer and influencing factors in Ethiopia. An institutional-based cross-sectional study was conducted in Gondar University Hospital, Ethiopia, to investigate foot ulcer occurrence in diabetic patients. Systematic random sampling was used to select 279 study participants. Bivariate and multivariable logistic regression model was fitted to identify factors associated with diabetic foot ulcer. Odds ratio with 95% confidence interval was computed to determine the level of significance. Diabetic foot ulcer was found to be 13.6%. Rural residence [AOR = 2.57; 95% CI: 1.42, 5.93], type II diabetes mellitus [AOR = 2.58; 95% CI: 1.22, 6.45], overweight [AOR = 2.12; 95% CI: 1.15, 3.10], obesity [AOR = 2.65; 95% CI: 1.25, 5.83], poor foot self-care practice [AOR = 2.52; 95% CI: 1.21, 6.53], and neuropathy [AOR = 21.76; 95% CI: 8.43, 57.47] were factors associated with diabetic foot ulcer. Diabetic foot ulcer was found to be high. Provision of special emphasis for rural residence, decreasing excessive weight gain, managing neuropathy, and promoting foot self-care practice would decrease diabetic foot ulcer.

Download Full-text

DIABETIC FOOT INFECTIONS;

The Professional Medical Journal ◽

10.29309/tpmj/2008.15.01.2718 ◽

2008 ◽

Vol 15 (01) ◽

pp. 153-161

Author(s):

MUHAMMAD SAEED AKHTAR ◽

MAQSOOD AHMAD ◽

MUHAMMAD BADAR BASHIR ◽

Muhammad Irfan ◽

Zahid Yasin Hashmie

Keyword(s):

Diabetic Foot ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Diabetic Patients ◽

Surgical Department ◽

Diabetic Foot Infections ◽

Group A ◽

Hospital Stays ◽

Male Patients ◽

Group B

Objective: (1) To evaluate the effects of G-CSF in eliminating infection in diabetic foot wound (2) Tocompare the effects with conventional diabetic foot management. Design: Prospective, open, randomized comparativestudy. Setting: Medical&Surgical Department of Allied, DHQ Hospital & Nawaz Medicare Faisalabad. Period: FromJan 2000 to Nov 2000 Patients & Methods: Fifty diabetic patients with foot infections were included in this study. Themean age was 52 years ranging from 27 to 60 years. They were divided into two equal groups(Group A and Group B).Results: The male patients were 41(82%) and female 9(18%). Forty six percent of patients were on oral hypoglycaemicdrugs, and 54% on insulin. The trauma preceding infection was 20%, Peripheral neuropathy 94% and peripheralvascular disease 34%. Thirty two percent of patients were smoker. Group A were subjected to G-CSF ( Neupogen )therapy (n=25) subcutanously daily for 5days in addition to conventional measures. Whereas patients in Group Breceived only conventional therapy. Both groups received similar antibiotic and insulin treatment. G-CSF therapy wasassociated with earlier eradication of pathogens from the infected ulcer (median 5 [range 2-11] vs11 [6-31] days in thegroup B; (p=<O.000I), quicker resolution of cellulitis (6 vs l4 days; p<O.0001), shorter hospital stay (8 vsl6 days;p<O.000l), and a shorter duration of intravenous antibiotic treatment (7 vs l4 days ;p—0.0001).No G-CSF treatedpatient needed surgery, whereas three patients in group B underwent toe amputation and six had extensivedebridement under anaesthesia (p=0.00 1). G-CSF therapy was generally well tolerated. Conclusion: Granulocytecolony stimulating factor (G-CSF) may be used as a good adjuvant therapy along with conventional measures for themanagement of diabetic foot infection, as it promotes the healing of diabetic foot ulcer/cellulitis and consequentlyprevents many hazardous complications like amputation of limbs, long hospital stays, extensive and prolonged antibioticuse and last but not the least the total misery of the patients.

Download Full-text

Osteomyelitis, diabetic foot ulcers and the role of the community nurse

British Journal of Community Nursing ◽

10.12968/bjcn.2021.26.sup6.s6 ◽

2021 ◽

Vol 26 (Sup6) ◽

pp. S6-S9

Author(s):

Melanie Lumbers

Keyword(s):

Diabetic Foot ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Holistic Approach ◽

Diabetic Patients ◽

Positive Outcomes ◽

Community Nurse ◽

Complex Needs ◽

Health And Wellbeing

Community nurses face numerous challenges in both diagnosing and effectively treating their patients. The diabetic patient has complex needs requiring a holistic approach. With a reported increase in diabetic patients, and a possible decline in some routine screening following Covid-19 pandemic, complications in diabetic patients are likely to rise. It is estimated that 25% of diabetic patients will develop a diabetic foot ulcer (DFU), with a reported 43% of DFU already infected at first presentation to a health professional. NICE categorise the level of infection in DFU based on standardised assessments such as SINBAD. A high categorised DFU has the possibility of osteomyelitis. It is imperative that osteomyelitis is treated immediately to achieve positive outcomes, benefitting the patients' health and wellbeing in addition to reducing the financial implications to the NHS.

Download Full-text