MOIST DRESSING AND OFF-LOADING USING A CRUTCH TOWARDS THE RECOVERY OF DIABETIC FOOT ULCER

Doni Setiyawan

Abstract


Diabetic foot ulcer is one of the serious complications on diabetes mellitus patient. There are three main and important principals in diabetic foot ulcer treatment: infection control, debridement, and off - loading. The infection control can be done using moist dressing that can stimulate and recover the wound fastly. Alternative off-loading can be done using simple tool such as crutch which is easily available with affordable price without decreasing the principal of off-loading. Analyze the effects of moist dressing and off-loading using crutch towards healing of diabetic foot ulcer in patient with diabetes mellitus.The design of this research was quasi eperimental with pre -test post-test control group design. The total number of the sample was 30 respondents that divided into 3 groups. The Intervention Group 1, the moist dressing and off-loading using crutch for 1,83 hours/day. The Intervention Group 2, the moist dressing and off - loading using crutch for 3,19 hours/day and the last group was controlling group. The data collecting technique used non probability sampling with consecutive sampling method and analyzed using paired t -test, one way annova, and linier regression. The scoring assesment of wound recovery used Bates Jansen Wound Assessment Tools (BJWAT). The score of BJWAT between Intervention Group 1 and Intervention Group 2 is p=0.049. The score of BJWAT between Intervention Group 1 and Controlling Group is p=0.256. The score of BJWAT between Intervention Group 2 and Controlling Group is p=0.650. Moist dressing and off-loading using crutch has affected the recovery of diabetic foot ulcer on proliferation phase. Moist dressing and offloading using crutch is one of the most influential factors towards the recovery of diabetic foot ulcer compared to the peripheral vascularity, blood glucose, and nutritional status.

Keywords: Diabetic foot ulcers, Off-loading, Moist dressing, BJWAT, Wound recovery


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Guariguata, L. Whiting, D. R., Hambleton, I., Beagley, J., Linnenkamp, U., Shaw, J. E. (2013). Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Research and Clinical Practice , Volume 103 , Issue 2 , 137 – 149

Singh, N., Armstrong, D. G., Lipsky, B. A. (2005). Preventing foot ulcers in patients with

diabetes. Journal of the American Medical Association, 293(2),217–228 http://jama.jamanetwork.com/journal.aspx

Sumpio,B. E. (2000). Primary Care Foot Ulcers. The New England Journal of Medicine. 343: 787-793 DOI: 10.1056/NEJM200009143431107 http://www.nejm.org/

Perkeni. (2009). Pedoman Penatalaksanaan Kaki Diabetik. Jakarta : PB Perkeni

Bowker, J.H., & Pfeifer, M.A. (2008).The Diabetic Foot. Philadelphia: Mosby Elsevier

Bryant, R.A., & Nix, P.N. (2007). Acute and chronic wound: current management concepts. St.

Louis, Missouri: Mosby Elsevier

Clayton, W. Elasy, T. A. (2009). A Review Of The Pathophysiology, Classification, And Treatment Of Foot Ulcers In Diabetic Patients. Clinical Diabetes, vol. 27 no. 2 52-58, doi:10.2337/diaclin.27.2.52

Delmas, L. (2006). Best Practice In The Assessment And Management Of Diabetic Foot Ulce rs. Rehabilitation Nursing, volume 31, issue 6, pages 228–234, DOI: 10.1002/j.2048-7940.2006.tb00018.x http://onlinelibrary.wiley.com/

Jeffcoate, W. J., Harding, K. G. (2003). Diabetic foot ulcers. The Lancet. DOI:http://dx.doi.org/10.1016/S0140-6736(03)13169-8

Kruse, I. Edelman, S. (2006). Evaluation and Treatment of Diabetic Foot Ulcers. Clinical Diabetes, vol. 24 no. 2 91-93, doi: 10.2337/diaclin.24.2.91

Cavanagh, P.R., Lipsky, B.A., Bradbury, A.W., & Botek, G. (2005). Treatment for diabetic foot ulcers. The Lancet, vol. 366, no. 9498, pp. 1725-35

Bus, S. A. (2008). The effectiveness of footwear and offloading interventions to prevent and heal foot ulcers and reduce plantar pressure in diabetes: A systematic review. Diabetes/Metabolism Research And Reviews. Published online in Wiley InterScience

www.interscience.wiley.com

Borrelli, J., Haslach, H., W., Jr. (2013). Experimental characterization of axillary/underarm interface pressure in swing-through crutch walking. Journal of Rehabilitation Research and

Development, Volume 50, Number 3, Pages 423–436

Fernando, M. E., Crowther, R. G., Pappas, E., Lazzarini, P. A., Cunningham, M., et al. (2014). Plantar Pressure in Diabetic Peripheral Neuropathy Patients with Active Foot Ulceration, Previous Ulceration and No History of Ulceration: A Meta-Analysis of

Observational Studies. PLoS ONE 9(6): e99050. doi:10.1371/journal.pone. 0099050

Frykberg, R. G., Zgonis, T., Armstrong, D. G., Driver, V. R., Giurini. J. M., Kravitz, S. R. (2006). Diabetic foot disorders: A clinical practice guideline (2006 revision). Journal of Foot and Ankle Surgery, 45(S5), S1–S66 www.jfas.org

Yotsu, R. R., et al. (2014). Comparison of characteristics and healing course of diabetic foot ulcers by etiological classification: Neuropathic, ischemic, and neuro-ischemic type. Journal of Diabetes and Its Complications, 28 :528–535

American Diabetes Association. (2013). Diagnosis and classification of diabetes mellitus diakses pada 25 januari 2016 dari www.diabetes.org

Sibbald, R. G., Keast, D. H. (2006). Best practice recommendations for preparing the wound bed: Update 2006, clinical practice, wound care. Canada

Brunner & Suddarth. (2005). Textbook of Medical Surgical Nursing.10th Edition. E-book

Lemone, P. Burke,K. (2004). Medical Surgical Nursing: Critical Thinking in Client Care. United

State of America: Pearson Education, Inc.

Suriadi. (2015). Pengkajian Luka & Penanganannya. Jakarta : CV Sagung Seto.

Sastroasmoro, S. Ismael, S. (2014). Dasar-dasar Metodologi Penelitian Klinis Edisi ke-5. Jakarta : CV Sagung Seto

Potter, Patricia A. dan Anne G. Perry. (2009). Fundamental Keperawatan Buku 1. Ed. 7. Jakarta : Salemba Medika

Huda, N. (2010). Pengaruh Hierbarik Oksigen Terhadap Perfusi Perifer Luka Gangren Pada Penderita DM Di RSAL Dr. Ramelan Surabaya. Tesis. Universitas Indonesia. Jakarta.

Maryunani, A. (2013). Perawatan luka modern (Modern Wound Care) terkini dan terlengkap sebagai bentuk tindakan keperawatan mandiri. Jakarta: In Media.

Rusjiyanto. (2009). Pengaruh Pemberian Suplemen Zinc dan Vitamin C Terhadap Kecepatan Penyembuhan Luka Pasca Bedah di Rumah Sakit Umum Daerah Kabupaten Sukoharjo. Penelitian. Sukoharjo.

Wulandari, I. (2010). Pengaruh Elevasi Ekstremitas Bawah Terhadap Proses Penyembuhan Ulkus Diabetik Di Wilayah Banten. Tesis. Universitas Indonesia. Jakarta

Aguiar, et al. (2003). History of Foot Ulcer Among Persons With Diabetes United States. www.ndep.nih.gov/diabetes/pubs/feet_kit_eng.pdf

Guo, S. and L. A. DiPietro. (2010). Factors Affecting Wound Healing. Critical Review in Oral Biology & Medicine. USA. J Dent Res 89930: 219-229

Chen, H., Tan, C., Lin, Z., & Wu, T. (2014). The diagnostics of diabetes mellitus based on ensemble modeling and hair/urine element level analysis. Computers in Biology and Medicine, 50, 70-5 http://dx.doi.org/10.1016/j.compbiomed

Keast, D., & Orsted, H. (2008). The Basic Principies of Wound Healing. Journal of Poediatry www.pilonidal.org

Sinno, H., & Prakash, S. (2013). Complements and the Wound Healing Cascade: An Updated Review. Plastic Surgery International, article id 146764, 7 pages http://dx.doi.org/10.1155/2013/146764

Syabariyah, S. (2015).Vibration Adjuvant Wound Therapy Enhances The Healing of Diabetic Foot Ulcers: An Interim Analysis of 31 Patient. Jurnal Online Keperawatan Dan Kesehatan Stik Muhammadiyah Pontianak, vol 5 no 2 http://journal.stikmuhptk.ac.id/

Obermeyer, A., et al. (2008). Venous Reflux Surgery Promotes Venous Leg Ulcer Healing Depsite Reduce Ankle Brachial Pressure Index. International Angiology

Margolis, D. J. (2009). Phase I Study Of H5.020CMV.PDGF-Beta To Treat Venous Leg Ulcer Disease. Molecular Therapy

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835007/

Falanga, V. (2005). Wound Healing and Its Impairment in The Diabetic Foot. Boston : The Lancet

Pearson, C. (2006). How Wounds Heal: A Guide For The Wound Care Novice. Wound Care Canada.

Suryaatmadja, M. (2003). Prinsip Dasar Ilmu Gizi. Jakarta : Gramedia Pustaka

Mackay, D., & Miller, A. (2003). Nutritional Support for Wound Healing. http://thorne.com


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