Karakteristik Ulkus Diabetikum pada Penderita Diabetes Mellitus di RSUD dr. Zainal Abidin dan RSUD Meuraxa Banda Aceh

Eka Fitria, Abidah Nur, Nelly Marissa, Nur Ramadhan

Abstract


Abstract
Diabetic mellitus remains prevalent in the world. It is a condition of hyperglycemia which are at risk of macrovascular and microvascular complications. One of diabetes complications is diabetic ulcers caused by loss of sensation of pain due to neuropathy. The research objective was to assess the characteristics of ulcers in diabetic patients in two general hospitals in Banda Aceh with cross sectional study design with purposive sampling. This study planned to observe a number of 215 diabetic patients. There were 57 people with diabetic ulcers including inpatients and outpatients in two general hospitals in Banda Aceh in the period November- December 2015. Observations were made to assess characteristics of ulcer sufferers. The result showed characteristics of Meggitt Wagner grade 1 ulcer criteria who were dominated by women. Other characteristics included the number of ulcer in only one place, location on foot, minimal exudate, such as a cliff-edged ulcer, skin around the ulcer has minimal inflammation in red pale, ulcer without pain and without maceration. Patients with diabetic ulcers should always observe hygiene, foot health and wound care.

Keywords : Characteristic of diabetic ulcer, Diabetes Mellitus, neuropathy, foot care

Abstrak
Diabetes mellitus masih menjadi masalah kesehatan di dunia. DM merupakan kondisi meningkatnya kadar gula darah yang berisiko menimbulkan komplikasi makrovaskular dan mikrovaskular. Prevalensi DM terus meningkat di seluruh dunia, termasuk di Indonesia. Salah satu komplikasi DM adalah ulkus diabetikum yang terjadi akibat berkurangnya sensasi nyeri karena neuropati. Tujuan penelitian adalah menilai karakteristik ulkus pada penderita DM di dua rumah sakit umum Kota
Banda Aceh. Jenis penelitian adalah observasional dengan desain potong lintang. Teknik pengambilan sampel adalah secara purposive. Penelitian ini direncanakan mengamati ulkus diabetikum pada 215 pasien DM. Sampel yang didapatkan berjumlah 57 orang penderita ulkus diabetikum yang dirawat dan berobat jalan di dua rumah sakit umum Banda Aceh periode November sampai Desember 2015. Pengamatan dilakukan untuk menilai karakteristik ulkus yang diderita oleh responden. Hasil
penelitian didapatkan karakteristik ulkus diabetikum kriteria Meggitt Wagner grade 1 didominasi oleh perempuan. Karakteristik lainnya berturut-turut adalah jumlah ulkus hanya pada satu tempat, lokasi di kaki, eksudat minimal, ulkus bertepi seperti tebing, kulit di sekitar ulkus dengan inflamasi minimal berwarna merah muda, ulkus tanpa nyeri dan tanpa maserasi. Penderita ulkus diabetikum hendaknya selalu memperhatikan kebersihan, kesehatan kaki dan melakukan perawatan luka.

Kata kunci : Karakteristik ulkus diabetikum, Diabetes Mellitus, neuropati, perawatan kaki


References


World Health Organization, International Diabetes Federation. Definition and diagnosis of Diabetes Mellitus and intermediate hyperglicaemia. Report of WHO/IDF Consultation [internet]. 2006 [cited 2017 April 14]: [50]. Available from http://www.who.int/diabetes/publications/Definition% 20and%20diagnosis%20of%20diabetes_ new.pdf.

Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Atlas. Diabetes Research and Clinical Practice. 2010; (87): 4-14.

Badan Penelitian dan Pengembangan Kesehatan. Laporan hasil riset kesehatan dasar tahun 2013. Jakarta: Kementerian Kesehatan ; 2013.

American Diabetes Association. Standard of medical care in diabetes-2015. Diabetes Care [internet]. 2015. January [cited 2017 April 14]; 38(1): [93]. Available from http://care.diabetesjournals.org/content/ suppl/2014/12/23/38.Supplement_1.DC1/ January_Supplement_Combined_Final.6-99.pdf.

Perkumpulan Endokrinologi Indonesia. Konsensus pengendalian dan pencegahan diabetes mellitus tipe 2 di Indonesia 2011. Jakarta : PB Perkeni; 2011.

Bilous R, Donelly R. Buku pegangan diabetes. Ed 4. Jakarta: Bumi Medika; 2014.

Schteingart DE. Pankreas: metabolisme glukosa dan diabetes mellitus. In: Hartanto H, Susi N, Wulansari P, Mahanani DA, editors. Patofisiologi konsep klinis proses-proses penyakit. Jakarta: EGC; 2005.

Purwanti OS. Analisis faktor-faktor risiko terjadi ulkus kaki pada pasien diabetes mellitus di RSUD DR. Moewardi [thesis]. Depok: Universitas Indonesia; 2013.

Roza RL, Afriant R, Edward Z. Faktor risiko terjadinya ulkus diabetikum pada pasien diabetes mellitus yang dirawat jalan dan inap di RSUP Dr. M. Djamil dan RSI Ibnu Sina Padang. Jurnal Kesehatan Andalas. 2015; 4(1): 243-248.

Kartika RW. Pengelolaan gangren kaki diabetik. CDK. 2017; 44(1): 18-22.

Sadikin LM. Coping stres pada penderita diabetes mellitus pasca amputasi. Jurnal Psikologi dan Kesehatan Mental. 2013; 02(03): 17-23.

Jain AKC. A new classification of diabetic foot complications.: a simple and effective teaching tool. The Journal of Diabetic Foot Complication. 2012; 4(1):1-5.

Kahuripan A, Andrajati R, Syafridani T. Analisis pemberian antibiotik berdasarkan hasil uji sensitivitas terhadap pencapaian clinical outcome pasien infeksi ulkus diabetik di RSUD DR. H. Abdul Moeloek Lampung. Majalah Ilmu Kefarmasian. 2009; 6(2): 75-87.

Decroli E, Karimi J, Manaf A, Syahbuddin S. Profil ulkus diabetik pada penderita rawat inap di bagian penyakit dalam RSUP Dr. M. Djamil Padang. Maj Kedokt Indon. 2008; 58(1): 3-7.

Lukito AA, Rahajoe AU, Rilantono LI, Harimurti GM, Soesanto AM, Danny SS, dkk. Pedoman tatalaksana pencegahan penyakit kardiovaskular pada perempuan. Jakarta : Perhimpunan Dokter Spesialis Kardiovaskular Indonesia; 2015.

Utami DT, Karim D, Agrina. Faktor-faktor yang mempengaruhi kualitas hidup pasien diabetes mellitus dengan ulkus diabetikum. JOM PSIK. 2014; 1(2): 1-7.

Agency for Healthcare Research and Quality. Prevalence of diabetes, diabetic foot ulcer, and lower extremity amputation among medicare beneficiaries, 2006 to 2008. Effecive Health Care Program. 2011;10 (11): 1-7.

Gupta A, Haq M, Singh M. Management option in diabetic foot according to Wagners classification: an observational study. Jk Science. 2016; 18(1): 35-38.

Burzawa JK, Schmeler KM, Soliman PT, Meyer LA, Bevers MW, Pustilnik TL, et al. Prospective evaluation of insulin resistance among endometrial cancer patients. Am J Obstet Gynecol. 2011; 204 (4): 1-15.

Suba Z. Low esterogen exposure and/or defective esterogen signaling induces disturbances in glucose uptake and energy expenditure. J Diabetes Metab. 2013; 4(5):1-10.

Levin ME. An Overview of The Diabetic Foot : Pathogenesis, management and prevention of lesions. Int. J. Diab. Dev.Countries. 1994; 14: 39- 47.

Martha A. Analisis faktor-faktor risiko yang berhubungan dengan penyakit diabetes mellitus pada perusahaan x. [thesis]. Depok: Universitas Indonesia; 2012.

Rodrigues J, Mitta N. Diabetic foot and gangrene. Department of Surgery, GOA Medical Collage, India. 2011.

Oyibo S, Jude EB, Tarawneh I, Nguyen HC, Harkless L, Boulton AJM. A comparison of two diabetic foot ucer classification system the wagner and the university of texas wound classification systems. Diabetes Care. 2001; 24(1):84-88.

Hakimsyah. Peranan infeksi terhadap kejadian amputasi pada kaki diabetik. [thesis]. Semarang: Universitas Diponegoro; 1999.

Aulia NF. Pola kuman aerob dan sensitifitas pada gangren diabetik. [thesis]. Medan: Universitas Sumatera Utara; 2008.

Munter C, Price PP, Werven WR, Sibbald G. Diabetic foot ulcers-prevention and treatment . A Coloplast Quick Guide. 2012.

Yazdanpanah L, Nasiri M, Adarvishi S. Literature review on the management of diabetic foot ulcer. World Journal of Diabetes. 2015; 6(1):37-53.

Lipsky BA, Berendt AR, Cornia PB, Pile JC, Peters EJG, Armstrong DG, et al. Infection diseases society of america clinical practice guideline for the diagnosis and treatment of diabetic foot infections. Clinical Infectious Diseases. 2012; 54(12): 132-173.

Swanson T, Grothier L, Schultz G. Wound made infection easy. Wounds International [internet]. 2014. [cited 2017 April 3]; [6]. Available from http://www.woundsinternational.com/media/other- resources/_/1152/files/wi-made-easy.pdf.

Wu SC, Driver VR, Wrobel JS, Armstrong DG. Foot ulcers in the diabetic patient, prevention and treatment. Vasc Health Risk Manag. 2007; 3(1): 65-76.

American Diabetic Association. Microvascular complications and foot care. Diabetes care. [internet]. 2015. [cited 2017 April 13]. Available from http://care.diabetesjournals.org/content/38/ Supplement_1/S58

National Diabetes Education Program. Diabetes foot and skin care. [internet]. June 2017. [cited 2017 August 4]. Available from https://www.cdc. gov/diabetes/diabetesatwork/pdfs/diabetesfootandskincare. pdf


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