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This document summarizes the pathogenesis and management of diabetic foot ulcers. It states that the prevalence of diabetic foot ulcers is 4-10% of the general population, with higher rates in elderly people. Approximately 14-24% of patients with diabetic foot ulcers require amputations, with a 50% recurrence rate after three years. The main causes of diabetic foot ulcers are neuropathy and peripheral arterial disease. Management involves treating ischemia, debridement of necrotic tissue, wound treatment, off-loading the affected foot, managing comorbidities and infections, and preventing recurrences.

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22 views1 page

864 1714 1 SM

This document summarizes the pathogenesis and management of diabetic foot ulcers. It states that the prevalence of diabetic foot ulcers is 4-10% of the general population, with higher rates in elderly people. Approximately 14-24% of patients with diabetic foot ulcers require amputations, with a 50% recurrence rate after three years. The main causes of diabetic foot ulcers are neuropathy and peripheral arterial disease. Management involves treating ischemia, debridement of necrotic tissue, wound treatment, off-loading the affected foot, managing comorbidities and infections, and preventing recurrences.

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Lestary Susanto
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© © All Rights Reserved
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Jurnal Biomedik, Volume 3, Nomor 2, Juli 2011, hlm.

95-101

PENATALAKSANAAN ULKUS KAKI DIABETES


SECARA TERPADU

Yuanita A. Langi
Bagian Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Sam Ratulangi Manado
Email: meralday@yahoo.co.id
Abstract: A diabetic foot ulcer is a common and fearful chronic complication of diabetes
mellitus often resulting in amputation, and even death. A diabetic foot ulcer can be prevented
by early screening and education in high risk individuals, and the management of underlying
conditions such as neuropathy, peripheral arterial disease, and deformity. The prevalence of
diabetic foot ulcer patients is 4-10% of the general population, with a higher prevalence in
elderly people. Around 14-24 % of diabetic foot ulcer patients need amputations with a
recurrence rate of 50% after three years. The main pathogenesis of diabetic foot ulcer is
neuropathy and peripheral arterial disease (PAD). PAD contributes to diabetic foot ulcers in
50% of cases; however, it rarely stands alone. Other factors such as smoking, hypertension,
and hyperlipidemia may contribute, too. In addition, PAD reduces the access of oxygen and
antibiotics to the ulcers. Management of diabetic foot ulcers includes treatment of ischemia by
promoting tissue perfusion, debridement for removing necrotic tissues, wound treatment for
creating moist wound healing, off-loading the affected foot, surgery intervention, management
of the co-morbidities and infections, and prevention of wound recurrences. Other adjuvant
modalities include hyperbaric oxygen treatment, GCSF, growth factors, and bioengineered
tissues.
Key words: diabetic ulcer, debridement, off loading
Abstrak: Ulkus kaki diabetes (UKD) merupakan salah satu komplikasi kronik diabetes
melitus yang sering dijumpai dan ditakuti oleh karena pengelolaannya sering mengecewakan
dan berakhir dengan amputasi, bahkan kematian. UKD dapat dicegah dengan melakukan
skrining dini serta edukasi pada kelompok berisiko tinggi, dan penanganan penyebab dasar
seperti neuropati, penyakit artei perifer dan deformitas. Prevalensi pasien UKD berkisar 410% dari populasi umumnya, dengan prevalensi yang lebih tinggi pada manula. Sekitar 1424% pasien UKD memerlukan amputasi dengan rekurensi 50 % setelah tiga tahun.
Patogenesis utama UKD yaitu neuropati dan penyakit arteri perifer (PAP). PAP berkontribusi
50% pada pasien UKD, tetapi hal ini jarang dijumpai tunggal. Terdapat faktor-faktor lain yang
turut berperan seperti merokok, hipertensi dan hiperlipidemia. Selain itu PAP menurunkan
akses oksigen dan antibiotik ke dalam ulkus. Penatalaksanaan UKD meliputi penanganan
iskemia dengan meningkatkan perfusi jaringan, debridemen untuk mengeluarkan jaringan
nekrotik, perawatan luka untuk menghasilkan moist wound healing, off-loading kaki yang
terkena, intervensi bedah, pananganan komorbiditas dan infeksi, serta pencegahan rekurensi
luka. Terapi ajuvan meliputi terapi oksigen hiperbarik, pemberian granulocyte colony
stimulating factors (GCSF), growth factors dan bioengineerd tissues.
Kata kunci: ulkus diabetes, debridemen, off loading

95

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