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Lab :
RBG : 294
Leuco :26.970
Ro pedis : gas gangren
(+)
LAB
Hb: 8.8
WBC :26.970
POMR
CUE AND CLUE PL Idx PDx PTx PMo
Male/58 yo 4. HT St II 4.1. Primary Fundusco PO: Captopril 3x25 mg S,VS,
History of 4.2. Secondary py UOP
hypertyension since 3
years ago
BP: 170/90 mmHg
Social,low
economic,low
Diabetic foot Septic
education condition
Periferal arterial desease
Bad compliance
Macroangiopathy Nefropathy
Azotemia
DM type 2
Microangiopathy
Risk Factor Analysis
Diabetes melitus Diabetic foot ulceration
1. Obesity 1. Diabetik neuropathy
2. Sedentary lifestyle 2. Long standing DM
3. Dislipidemia 3. Over 40% of type 2 DM
4. Unhealthy eating habit patients had significant
5. Family history and neuropath
genetics
6. Increased age
7. High Blood Pressure
and high cholesterol
8. History of gestasional
Diabetes
Risk factor sepsis
Very young people and elderly people
Anyone who is taking immunosuppressive medications (such as transplant
recipients)
People who are being treated with chemotherapy drugs or radiation
People who have had their spleen surgically removed (the spleen helps
fight certain infections)
People taking steroids (especially over the long term)
People with longstanding diabetes, AIDS, or cirrhosis
Someone who has very large burns or severe injuries
People with infections such as
pneumonia,
meningitis,
SBP
cellulitis,
urinary tract infection
Manajemen analysis
Emergency
1. Diabetic foot
Inj Ceftriaxon 2x1 g iv
Inf metronidazol 3x500mg
Wound toilet
Debridement
Manajemen analysis
Urgency
2. Septic condition
Diet DM 1800 Kcal/day, low salt < 2 gram/day
Inj Ceftriaxon 2x1 g iv
Inf metronidazol 3x500mg
Wound toilet
Debridement
Manajemen analysis
3. HT ST 2
Po: Captopril 3x25 mg
4. Anemia NN
Transfusion 2 kolf/hr until RBS>10
Condition this morning
BP:
PR
RR:
Tax
UOP:
Klasifikasi Wagner
Derajat 0 : Tidak ada lesi terbuka, kulit masih utuh dengan
kemungkinan disertai kelainan bentuk kaki seperti claw,
callus.
Derajat I : Ulkus superficial terbatas pada kulit.
Derajat II : Ulkus dalam menembus tendon dan tulang.
Derajat III : Abses dalam, dengan atau tanpa osteomielitis.
Derajat IV : Gangren jari kaki atau bagian distal kaki dengan
atau tanpa selulitis.
Derajat V : Gangren seluruh kaki atau sebagian tungka