MANAJEMEN

LUKA DIABETES
IRMA P. ARISANTY
Patofisiologi kaki diabetik
KONDISI KAKI dm
Luka KAKI DM Luk a Kaki dm
. .
KONDISI KAKI
NEUROPHATIC NEURO-ISCHENIC DENGAN
DENGAN PULSASI BAIK MATI RASA DAN ISCHEMIA
Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6

Normal Kaki resiko Kaki ulkus Kaki infeski Kaki Kaki yg tidak
Tidak tinggi Ulkus pada Kudem nekrosis/ dapat di
terdapat Deformitas plantar Kulit Merah gangren selamatkan
kelaianan Kelainan Neuropati melibatkan Nekrosis
Infeksi kulit sub
kuku Kalus Ostio melites luas harus
kutis fasia , amputasi
Kulit kering Ulkus dasar Gejala sendi,tulang.
Otot nya otot sisitemik
hipotrofi

Klasifikasi Wagner
INSPEKSI:
FOOT DEFORMITIES

BLISTER

CALLUS / CORN

PERUBAHAN KAKI

FOOT WEAR
 FOOT DEFORMITIES
Pes Covus : Flat foot

Hammer toes : Claw

Charcots foot :
deformity

Bunions (Hallux vagus)

CALLUS - CORN
PRESSURE AREA
PERUBAHAN KAKI
KERING
ALOPECIA
HYPERPIGMENTASI
GATAL
ATROPI
HIPOEKRESI
FOOT WEAR EVALUATION
Foot map with size
Pressure are
Kind of shoes
PALPASI
PULSASI

SUHU KAKI

EDEMA
 INVESTIGASI
PULSES (VASCULAR)
Doopler
SENSATION
(NEUROLOGIC)
Sensation vibration
SWME : Semmes
Weinstein (10g)
Monifilament
Examination
X-RAY
TES MONOFILAMEN
FOOT RISK CLASSIFICATION
SYSTEM, Driver et al 2005
Sensation (-)
(neurologic)
Pulses (-)
(vascular)
Foot deformities (-) / (+) HIGH RISK
Sensation (+)
(neurologic)
Pulses (+)
(vascular)
DIABETES Foot deformities (+)

Sensation (+)
(neurologic) MODERATE
Pulses (+) LOW RISK
(vascular)
RISK
Foot deformities (-)
MANAJEMEN KAKI DIABET
EDUKASI
PERAWATAN KUKU KAKI
SENAMKAKI
PERAWATAN LUKA
EDUKASI
OLAHRAGA NUTRISI OBAT
TEPAT 3J
TEPAT JUMLAH
TEPAT JAM
TEPAT JENIS
PERAWATAN KUKU-KAKI : PENCEGAHAN
LUKA KAKI DIRUMAH
NAIL CARE

Foot soak for 10

Clean with baby soap
Drying foot with towel
Cut straight
not oval head
Clean nail
Soften nail
Soften calleous
SELF ASSESSMENT

Skin lesion check with mirror

Between toes
Pulse
Shoes
Challus or chorn (hyperkeratotic)
Xerosis
EXERCISES with tools
Shoes & shock
Soft, thick shoes (leather)

Soft, thick and warm shocks

INFECTED DIABETIC ULCER
 Ciri-ciri:
Gas gangrene

Krepitasi saat palpasi
sekitar luka
Exudate banyak
gelembung
Sangat sakit dg
tanda-tanda infeksi
lokal dan sistemik
Setelah dicuci
antiseptik masih
malodour

Manajemen:
Faciotomy
Wound care
PERSIAPAN DASAR LUKA
FASE PENUTUPAN
PERHATIKAN SATU KAKI
 DAFTAR PUSTAKA
Bryant A, Ruth, et.al. Acute and Chronic Wounds: Current Management Concepts. 3rd
Ed. Philadelphia: Mosbi Elsevier (2007), p.
Carville, Kerlyn. Wound Care Manual. 3rd Ed. Western Australia: Silver Chain Foundation
(1998), p160-200.
Soegondo Sidartawan, et.al. Penatalaksanaan Diabetes Militus Terpadu. Ed ke-7.
Jakarta: FK-UI. 2007.
Haddad L, Steven, et.al. AAOS (American Academy of Orthopedic Sugeons). October
2007 www.orthoinfo.org
http://www.foot.com/info
Comfort Shoe Specialists, 11693 Manchester Rd, St. Louis, MO 63131
www.comfortshoesspecialist.com
Ferry J, Robert . et.al. www.feetforlife.org.
Angsko, Arizona. www.footcaredirect.com.
WCET jurnal