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BERAPA LAMA LUKA INI AKAN SEMBUH?
Ulcers
• The incidence of diabetic foot ulcers is up to 25% over a
patient’s lifetime.
• The onset is variable in patients with type 1 diabetes.
• Foot ulcers occur in 15-25% of people with diabetes, which
equates to slightly more than 2% annually and between 5-
7.5% of those patients with neuropathy.
• Foot ulcers and infections are the most common reason for
hospital admission in people with diabetes in the United
States. The prevalence of diabetic ulcers is 7-8%.
• Since diabetes and obesity are growing at epidemic
proportions and with an increasing elderly population with
chronic conditions, will make coordinated care more essential
and valued.
Etiology
Using a monofilament to
test for neuropathy
Classification and severity of diabetic
foot infections
Classification for Diabetic Foot Infections – Saint Elian
Wound Score System and Infectious Disease Society of
America
Saint Elian Score System for 10 subcategorized wound
severity factors and III Grades for prognosis
Areas at risk for DFU
Charcot foot.
Top — Charcot foot
with plantar ulcer.
Middle — Charcot
foot with sepsis.
Bottom — Chronic
Charcot foot
Key features of common wound
classification systems for DFUs
Treatment
EPIDERMIS
DERMIS
HYPO DERMIS/
SUBCUTIS
WOUND STAGES
STAGE 1
Partial Thickness
Luka terjadi pada daerah Epidermis hingga
Dermis
Full Thickness
Terjadi kerusakan pada kulit, bisa terjadi
nekrosis pada daerah subkutan bahkan
hingga dibawah
fascia
ETHIOLOGY :
- Mechanical : pressure, shear, friction, stripping
- Chemical: Incontinence, drainage
- Vascular : Arterial ulcer, venous ulcer, diabetic ulcer, etc
- Infection: Candidiasis, herpes
- Allergic
- Miscellaneous: radiation, thermal
2. Wound Stages(1-4)
WOUND ASSESMENT
3. Wound Base
4. Type of tissue
WOUND ASSESMENT
5. Dimentions
6. Exudate
WOUND ASSESMENT
7. Wound Edges
8. Peri-wound skin
WOUND ASSESMENT
10. Sign of Infection
WOUND BED PREPARATION (WBP)
TUJUAN (WBP)
1. Menghilangkan faktor yang menghambat
penyembuhan luka
2. Meningkatkan support system autolytic
debridemant
3. Absorbsi Eksudat
4. Menghilangkan bau tidak sedap
5. Menghindari terjadinya infeksi
6. Mempersiapkan dasar luka, agar bisa di mulai
proses penyembuhan luka dengan baik, dibantu
dengan modern dressing
WOUND BED PREPARATION (WBP)
WOUND BASE COLOR /WARNA DASAR LUKA (Red, Yellow, Black)
1. RED (MERAH)
Warna dasar merah terang atau
merah tua, tampak lembab adalah
granulasi, vaskulerisasi baik tetapi
mudah berdarah
2. YELLOW (KUNING)
Dasar warna luka kuning/ kuning kecoklatan/ kuning pucat,
kondisi luka terkontaminasi, terinfekasi
Avaskularisasi dikenal dengan nama SLOUGH
WOUND BED PREPARATION (WBP)
WOUND BASE COLOR /WARNA DASAR LUKA (Red, Yellow, Black)
3. BLACK (HITAM)
Warna dasar luka hitam/ hitam kecoklatan/hitam kehijauan
merupakan jaringan nekrotik.
Avascularisasi
WOUND BED PREPARATION (WBP)
WOUND BASE COLOR /WARNA DASAR LUKA (Red, Yellow, Black)
4. BIO FILM
Biofilm didefinisikan sebagai komunitas mikroorganisme yang
membentuk kapsul dan didalam nya membangun polymeric
matrix yang sangat kuat, tekstur nya seperti agar- agar. Apabila
tidak di buang, maka WBP tidak terjadi dan proses
penyembuhan luka tidak dapat berjalan
WOUND BED PREPARATION (WBP)
TIME MANAGEMENT
WOUND BED PREPARATION (WBP)
TIME MANAGEMENT
T = TISSUE MANAGEMENT, remove
non viable tissue
Debridemant
• Surgical
• CSWD (Conservative Sharp WD)
• Autolysis Debridemant
• Mechanical Debridemant
• Biological Debridemant
WOUND BED PREPARATION (WBP)
TIME MANAGEMENT
I = INFLAMATION & INFECTION
CONTROL
• Mencuci luka dengan
menggunakan NaCl atau PHMB
• Diberikan dressing yang
mengandung ionic silver atau
anti mikroba topikal yang lain
• Apabila sudah terjadi infeksi
sistemik, maka perlu diberikan
tambahan obat antibiotik
WOUND BED PREPARATION (WBP)
TIME MANAGEMENT
M = MOISTURE BALLANCE