Академический Документы
Профессиональный Документы
Культура Документы
Saldy Yusuf.,PhD.,ETN
2
PREVALENSI DIABETES MELLITUS
2013 2035
PREVALENCE DM Populasi DM di Indonesia
Country Millions Country Millions
IN INDONESIA1,3,4 1
4
China 98.4 China 12 Juta 142.7
7.00% 1
5.7% 6% 2India 65.1 India 109.0
6.00% 10
USA 24.4 USA 29.7
5.00% 7 Juta
Brazil
8 11.9 Brazil 19.2
4.00% Russian 10.9 Mexico 15.7
6
3.00% Mexico 8.7 Indonesia 14.1
2.00% 1.63% 4
Indonesia 8.5 Egypt 13.1
1.00% 2
Germany 7.6 Pakistan 12.8
0.00%
Egypt
0 7.5 Turkey 11.8
1983 1 20072 20303
Japan 20107.2 Russian 2030 11.1
26 85.1
15
12 38.4
11 34.6
8 8
7
19.2
3 3 3 14.8
1 1 1 7.6
0 0
Saldy Yusuf., Sukmawati.,Mayumi Okuwa.,Junko Sugama. Development Enterostomal Therapy Nurse Outpatient Wound
Clinic In Indonesia: A Retrospective Descriptive Study. 2013. Wound Research and Practice. 21(1):41-47
Prevalence DFUs in Indonesia
• Prevalence of risks (neuropathy and angiopathy) in Hospital
Setting 55.4% (95% CI: 53.7-57.0%)
(Yusuf et al., 2015).
• Prevalence of DFUs:
– Hospital 12% (95% CI: 10.3-13.6%)
(Yusuf et al., 2015).
– Home care 26%
(Yusuf et al., 2013).
• One year observation; healing (64.7%), recurrence (17.6%),
dead (11.8%), unheal (5.9%)
(Baharia et al., 2014)
1. Yusuf, S., Okuwa, M., Irwan, M., Rassa, S., Laitung, B., Thalib, A., … Sugama, J. (2015). Prevalence and risk factor diabetic foot ulcers: A
cross sectional study among DM type 2 in eastern Indonesia. OWM Journal.
2. Yusuf, S., Kasim, S., Okuwa, M., & Sugama, J. (2013). Development of an enterostomal therapy nurse outpatient wound clinic in
Indonesia : a retrospective descriptive study. Wound Practice and Research, 21(1), 41–47.
3. Baharia Laitung, Muhammad Irwan, Saiful Rassa, Sukmawati, Saldy Yusuf. One year recurrence incidence and risk factors of diabetic foot
ulcer in Makassar, eastern Indonesia (pre eliminary study). 1st WOC Scientific Meeting, Yogyakarta 2014. 5
DFU status on 1st admission
Saldy Yusuf (2013) Current Status of Diabetic Foot Ulcers in Makasar, Indonesia. Baruga AP. Pettarani, 9
Desember 2013
DFU presence in one way
DIABETES MELLITUS
Neuropathy Angiopathy
Dry SkinToe
Onychocriptosis
Hammer Onychodistrofi Callus
Corn Bunion Onychogriposis Tinea Pedis
Onychomycosis
Hallux Vagus
PREPRE ULCERS:
ULCERS: NAIL
SKIN PROBLEMS
DEFORMITY PROBLEMS
PRE ULCER
Amputation AMPUTATION
Alternative?
8
Alternative Assessment
NEUROPATHY ANGIOPATHY
Avery, D. A. C. L., Lavery, L. A., Peters, E. J. G., Williams, J. R., Murdoch, D. P., Hudson, A., & LAvery, D. C. (2008). Reevaluating the Way We Classify the
International Working Group on the Diabetic Foot. Diabetes care, 31, 154–156. doi:10.2337/dc07-1302.Abbreviations
Our findings
Eligible: 259
Drop Out:
10
Analysis:
249 (inpatient 14)
Group 0: Group 1: Group 2A: Group 2B: Group 3A: Group 3B:
90 (36.1%) 14(5.6%) 64 (25.7%) 34 (13.7%) 14 (5.6 %) 3 (1.2%)
Yusuf, S., Okuwa, M., Irwan, M., et al (2016). Prevalence and Risk Factor of Diabetic Foot
Ulcers in a Regional Hospital , Eastern Indonesia. Open Journal of Nursing, 6, 1–10. 12
Advanced Assessment:
Mobile Infra Red Thermography
History
Milestone application infra red thermography in diabetic foot
Identification
Inflammation & sign Diagnosis
for foot disease neuropathy
Saldy Yusuf: Identification Clinical Features Diabetic Foot Ulcers Using Non-Contact Thermography Based On Mobile Phone: A
Case Series. WCET 2016 Conference, Cape Town, South Africa; 03/2016
Mobile Thermography as advanced assessment
Dorsal
Plantar
Clinical features showed necrotic area along side dorsal forefoot to medial, However
thermography findings identified “cold pattern” at all fingers and forefoot area.
Yusuf, S., Sukmawati, K., & Laitung, B. (2016). Identification Clinical Features Diabetic Foot Ulcers Using Non
Contact Thermography Based on Mobile Phone: A Case Series. In WCET 21st Biennial Congress.
Screening for risk
20
TIME CONCEPT
EWMA merekomendasikan:
1. Debridement secara berkala dan radikal.
2. Inspeksi dan kontrol bakteri.
3. Moisture balance untuk mencegah maserasi.
Moura, L. I. F., Dias, A. M. a, Carvalho, E., & de Sousa, H. C. (2013). Recent advances on the
development of wound dressings for diabetic foot ulcer treatment--a review. Acta
Biomaterialia, 9(7), 7093–114. doi:10.1016/j.actbio.2013.03.033
Proses Perawatan
26
Makoto Oe, et al 2014., unpublished data
Madu sebagai alternatif
0 day 2 day 5 day 7 day 11 day 14 day Indonesian Honey
group
Haryanto, Urai, T., Mukai, K., Suriadi, Sugama, J., & Nakatani, T. (2012). effectiveness of Indoensian Honey on the
Aceleration of Cutaneous WOund Healing: An Experimental Study in Mice. WOUNDS, 24(4), 110–119.
Madu sebagai alternatif
2
1.8
Ratio of areas to original areas
1.6 Control
Indo
1.4
Manuka
1.2 ** ** **
**
1
0.8 NS
0.6
0.4
0.2
0
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14
Days after wounding
Ratio of the wound area. Value was expressed Mean±SD. n = 6 per group .
ANOVA; Tukey-Kramer (** p < 0.01)
Haryanto, Urai, T., Mukai, K., Suriadi, Sugama, J., & Nakatani, T. (2012). effectiveness of Indoensian Honey on the
Aceleration of Cutaneous WOund Healing: An Experimental Study in Mice. WOUNDS, 24(4), 110–119.
Case Series
29
Case 1: Callus
Kanan
(Ada/absent)
Monofilament Absent
Pin Prick Absent
Palpasi
Dorsalis Pedis Absent
20 Sept 2013 23 Sept 2013 Posterior Tibialis Absent
ABPI
Dorsalis Pedis 1.1
Posterior Tibialis 0.6
16 September 2015
21 September 2015 13 Oktober 2015
LAPORAN KASUS
Luka Kaki Diabetic Wagner III
di Klinik Griya Afiat Makassar
1Griya Afiat Makassar, Wound Care and Home Care Clinic, Makassar, Indonesia.
2Chroni Wound Department, Kanazawa University Japan.
PROSES PERAWATAN
Baharia., Sukmawati., Saldy Yusuf (2014) Case Report: Honey Impregnated wound dressing in DFU Wagner III. Data on file.
EFEKTIFITAS
Efektifitas waktu:
• Lama perawatan : 82 hari.
• Frekuensi perawatan : 23 kali.
• Rata rata pergantian balutan : 4 hari.
• Rata-rata waktu perawatan: 30-60 menit.
Efektifitas dressing:
• Tidak nyeri.
• Bau terkontrol.
• Balutan tidak lepas.
Efektifitas hasil:
• Sembuh tanpa komplikasi.
• Sembuh tanpa amputasi (minor atau mayor).
Baharia., Sukmawati., Saldy Yusuf (2014) Case Report: Honey Impregnated wound dressing in DFU Wagner III. Data on file.
LAPORAN KASUS
Diabetic Ulcer Non Foot
di Klinik Griya Afiat Makassar
1Griya Afiat Makassar, Wound Care and Home Care Clinic, Makassar, Indonesia.
2Chroni Wound Department, Kanazawa University Japan.
Healing Progress
35
34
29 30 30 29 29
30 27
25 24
25
20 18
15 13
15
10
0
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15