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Oe M, Saad SS, Jais S, Sugama J. Impact of foot ulcer-related factors on quality of life in patients with diabetes: Prospective observational study. Int Wound J 2024; 21:e14895. [PMID: 38745309 PMCID: PMC11093921 DOI: 10.1111/iwj.14895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 04/14/2024] [Accepted: 04/17/2024] [Indexed: 05/16/2024] Open
Abstract
Quality of life (QOL) may be impacted by foot ulcer-related factors, with prevention of diabetes-related foot ulcers or more effective early healing helping to improve overall patient QOL. This study, which examined the relationship between foot ulcer-related factors and QOL in patients with diabetes, was conducted as a secondary analysis of a prospective observational study entitled: "Factors associated with the discontinuation of wound care specialist clinic visits in patients with diabetic foot ulcers". We investigated EQ-5D-5L, patient characteristics and foot ulcer-related factors of 73 patients with diabetes-related foot ulcers who visited one wound clinic in Indonesia between August 2020 and February 2021. Results showed that the mean health utility was 0.294 ± 0.371. Factors selected for the multiple regression analysis included inflammation/infection of DMIST, first-ever foot ulcer, and size of DMIST. First-ever foot ulcer (β = 0.309, p = 0.003) and size of DMIST (β = -0.316, p = 0.015) were significantly associated with the health utility (p < 0.001). Significant improvement in the health utility of 15 patients was observed when the ulcer healed (Wilcoxon signed-rank sum test, p = 0.001). In conclusion, not only ulcer severity but also the first-ever foot ulcer itself affected the QOL in patients with diabetes. These results suggest there will be a greater impact on the QOL of patients who develop diabetes-related foot ulcers for the first time, along with the importance of prevention and early healing, through early infection control and wound size reduction.
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Affiliation(s)
- Makoto Oe
- Institute of Medical, Pharmaceutical and Health SciencesKanazawa UniversityKanazawaJapan
| | | | - Suriadi Jais
- Institut Teknologi dan Kesehatan Muhammadiyah Kalimantan BaratPontianakIndonesia
| | - Junko Sugama
- Faculty of NursingFujita Health UniversityToyoakeJapan
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Oe M, Saad SS, Jais S, Sugama J. Differences in characteristics between first-ever foot ulcer and recurrent foot ulcer in patients with diabetes: Prospective observational study. Health Sci Rep 2024; 7:e2018. [PMID: 38572120 PMCID: PMC10987974 DOI: 10.1002/hsr2.2018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 03/09/2024] [Accepted: 03/12/2024] [Indexed: 04/05/2024] Open
Abstract
Background and Aims More effective preventive care can potentially be provided if the characteristics of both the first ever and the recurrent foot ulcers can be clarified. The purpose of this study was to characterize first ever and recurrent foot ulcers in diabetic patients. Methods This study was conducted as a secondary analysis of a prospective study that was entitled: "Factors associated with the discontinuation of wound care specialist clinic visits in patients with diabetic foot ulcers." In 73 diabetes-related foot ulcer patients who visited one wound clinic in Indonesia between August 2020 and February 2021, we investigated characteristics of the patients and wounds, healing period, and cost. Results Trauma was shown to be the primary cause of the diabetic foot ulcer in both the first ever foot ulcer (n = 48) and recurrent foot ulcer (n = 25) patient groups (95.8% and 100.0%, respectively). The DMIST score for the first ever foot ulcer patients was significantly higher than the DMIST score for the recurrent foot ulcers. This was found to be especially the case in the first ever foot ulcer patients, as not only were there signs of inflammation (45.8%), but there were also signs of local infection (35.4%), or osteomyelitis and signs of local infection (14.6%) present. In the eight first ever foot ulcer patients and in the nine recurrent ulcer patients who were able to be followed through complete healing, the costs found for the first ever foot ulcer patients were significantly higher as compared to the costs for the recurrent foot ulcer patients. Conclusion To avoid diabetes-related foot ulcers, specialized educational programs on trauma prevention need to be established. Moreover, patients without diabetes-related foot ulcer histories should be educated regarding the need to undergo early consultations before developing any infections.
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Affiliation(s)
- Makoto Oe
- Institute of Medical, Pharmaceutical and Health SciencesKanazawa UniversityKanazawaJapan
| | | | - Suriadi Jais
- Institut Teknologi dan Kesehatan Muhamamdiyah Kalimantan BaratPontianakIndonesia
| | - Junko Sugama
- Faculty of NursingFujita Health UniversityToyoakeJapan
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Jais S, Oe M, Sanada H, Sasongko A, Haryanto H. Evaluating the cost-effectiveness of diabetic foot ulcer management by wound care specialists in Indonesia. Wound Repair Regen 2024; 32:80-89. [PMID: 38149767 DOI: 10.1111/wrr.13147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 11/24/2023] [Accepted: 12/12/2023] [Indexed: 12/28/2023]
Abstract
Diabetic foot ulcers affect quality of life and economically burden patients and the Indonesian healthcare system. The comparative cost-effectiveness of wound care specialists in private practices (e.g., wound clinics) and wound care nurses in national hospitals remains unknown. Thus, we used a decision tree to compare the cost and healing rates for patients after 12 weeks of wound care. Uncertainty was addressed using one-way and probabilistic sensitivity analyses. Among 89 participants (42 in the national hospital and 47 in the private practice), no significant differences were observed between the two groups in terms of sex, age, education level, smoking status, duration of diabetes, Wagner wound classification, glycated haemoglobin levels, neuropathy status, ankle-brachial index, baseline characteristics, quality of life, DMIST (depth, maceration, inflammation/infection, size, tissue type of the wound bed, type of wound edge, and tunnelling/undermining) score and wound location (p > 0.05). However, significant differences were observed for days from first visit/assessment until complete healing, mean quality of life (p ≤ 0.001) and wound size (p = 0.047). Wound care specialists in private practices had a significantly lower cost of 2,804,423.3 Indonesian rupiah compared to 6,483,493.4 Indonesian rupiah for wound care nurses in national hospitals. The incremental cost-effectiveness ratio was -165,723.9. Therefore, wound care specialists in private practices are more cost-effective for managing diabetic foot ulcers. Probability sensitivity analysis confirmed that 80%-90% of the scenarios were cost-effective. These findings may inform healthcare resource allocation in Indonesia. Additionally, evidence-based cost-effectiveness measures were strengthened in private practices and national hospitals.
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Affiliation(s)
- Suriadi Jais
- Graduate Nursing Program, Institut Teknologi dan Kesehatan Muhammadiyah Kalbar, Pontianak, Kalimantan Barat, Indonesia
| | - Makoto Oe
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Hiromi Sanada
- Ishikawa Prefectural Nursing University, Kahoku-gun, Ishikawa, Japan
| | - Agung Sasongko
- Program Studi Manajemen Informatika, Universitas Bina Sarana Informatika, Pontianak, Indonesia
| | - Haryanto Haryanto
- Graduate Nursing Program, Institut Teknologi dan Kesehatan Muhammadiyah Kalbar, Pontianak, Kalimantan Barat, Indonesia
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Haryanto H, Amrullah S, Jais S, Supriadi S, Imran I, Sari Y. INDIFURUTO: A novel tool for assessing diabetic foot recurrence risk in type 2 diabetes. J Med Life 2023; 16:1514-1518. [PMID: 38313180 PMCID: PMC10835566 DOI: 10.25122/jml-2023-0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 07/24/2023] [Indexed: 02/06/2024] Open
Abstract
This study aimed to evaluate diabetic foot ulcer recurrence using the Indonesia Diabetic Foot Ulcer Recurrence Assessment Tool (INDIFURUTO), a new diabetic foot risk recurrence assessment tool. This study used a prospective cohort design. A total of thirty-three participants met the inclusion criteria. We used sensitivity, specificity values, AUC, and, respectively, a 95% confidence interval (CI) to calculate prognostic accuracy measures. The results showed that this study had an AUC of 0,97 [95% confidence interval (CI) 0.91-1.00]. The cut-off point (Youden Index) was <45, with sensitivity and specificity values of 100% and 90%, respectively. The utilization of this model can facilitate the monitoring and enhancement of foot ulcer recurrence prevention in individuals diagnosed with diabetes. This study showed that the new model had a high prediction. Therefore, this model better stratifies people at high risk of foot ulceration.
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Affiliation(s)
- Haryanto Haryanto
- Department of Medical Surgical, Wound Management and Critical Nursing, Institut Teknologi dan Kesehatan Muhammadiyah, Kalimantan Barat, Pontianak, Indonesia
| | - Syahid Amrullah
- Department of Medical Surgical, Wound Management and Critical Nursing, Institut Teknologi dan Kesehatan Muhammadiyah, Kalimantan Barat, Pontianak, Indonesia
| | - Suriadi Jais
- Department of Medical Surgical, Wound Management and Critical Nursing, Institut Teknologi dan Kesehatan Muhammadiyah, Kalimantan Barat, Pontianak, Indonesia
| | - Supriadi Supriadi
- Department of Medical Surgical, Wound Management and Critical Nursing, Institut Teknologi dan Kesehatan Muhammadiyah, Kalimantan Barat, Pontianak, Indonesia
| | - Imran Imran
- Department of Medical Surgical, Wound Management and Critical Nursing, Institut Teknologi dan Kesehatan Muhammadiyah, Kalimantan Barat, Pontianak, Indonesia
| | - Yunita Sari
- Department of Nursing, Faculty of Health Sciences, Universitas Jenderal Soedirman, Purwokerto, Indonesia
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Qin Q, Oe M, Nakagami G, Kashiwabara K, Sugama J, Sanada H, Jais S. The effectiveness of a thermography-driven preventive foot care protocol on the recurrence of diabetic foot ulcers in low-medical resource settings: An open-labeled randomized controlled trial. Int J Nurs Stud 2023; 146:104571. [PMID: 37586286 DOI: 10.1016/j.ijnurstu.2023.104571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 07/13/2023] [Accepted: 07/26/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND Plantar temperature monitoring, along with a comprehensive preventive foot care approach, is utilized to prevent recurrence of diabetic foot ulcers. However, there is a lack of standardized protocols for individuals with diabetic foot ulcer history in low-medical resource countries. OBJECTIVE This study investigated the efficacy of nurse-led, thermographic-evaluation-guided foot care in preventing diabetic foot ulcer recurrence in a low-medical resource country. DESIGN Single-blind, 1:1 allocation randomized controlled trial. SETTINGS Two wound care facilities with wound care nurse specialists in Indonesia. PARTICIPANTS 120 patients with a diabetic foot ulcer history. INTERVENTION In the intervention group, baseline risk assessment including smartphone thermography evaluation was performed. Personalized foot care and education were conducted monthly for participants whose thermographs showed increased foot lesion temperature at baseline risk assessment. The control group received usual care and education using a booklet at baseline. The follow-up period was six months. MAIN OUTCOME Time to recurrence was evaluated using Kaplan-Meier survival analysis, and between-group comparisons were performed using the log-rank test. Potential risk factors were incorporated into the multivariate Cox regression model. Secondary outcomes included quality of life (European Quality of Life 5 Dimensions 3 Level Version) and foot care behavior, were analyzed using Mixed Models for Repeated Measures at baseline, third, and sixth follow-up (3 and 6 months from baseline). RESULTS 120 participants (intervention 60, control 60) were randomized. The intervention group had a significantly lower recurrence rate than the control group (15% vs. 35%, p = 0.011) and a significant difference in time to ulceration (log-rank test, p = 0.009) after a 6-month follow-up period. Intervention care reduced the risk of diabetic foot ulcer recurrence by 59% (Hazard ratio 0.41, 95% confidence interval 0.18, 0.96, p = 0.039) in multivariate Cox regression analysis. On the third follow-up, total diabetic foot care behavior score (p < 0.001) was significantly improved by the intervention. On the sixth follow-up, mobility (p = 0.020), self-care (p = 0.023), pain/discomfort (p < 0.001), anxiety/depression (p = 0.016), EuroQol Visual Analogue Scale score (p = 0.002), and total diabetic foot care behavior score (p < 0.001) showed significant improvements in the intervention group. CONCLUSIONS Foot care and personalized education delivered at a frequency based on the risk level assessed by thermography effectively reduced diabetic foot ulcer recurrence, and improved quality of life and foot care behaviors. REGISTRATION NUMBER UMIN000039012. TWEETABLE ABSTRACT Nurse-led diabetic foot care and education reduced diabetic foot ulcer recurrence in Indonesia.
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Affiliation(s)
- Qi Qin
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Makoto Oe
- Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Gojiro Nakagami
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kosuke Kashiwabara
- Biostatistics Division, Central Coordinating Unit, Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan
| | - Junko Sugama
- Research Center for Implementation Nursing Science Initiative, Research Promotion Headquarters, Fujita Health University, Aichi, Japan
| | - Hiromi Sanada
- Ishikawa Prefectural Nursing University, Ishikawa, Japan
| | - Suriadi Jais
- The Nursing Institute of Muhammadiyah Pontianak, Pontianak, Indonesia.
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Jais S, Pratama K. A diabetic foot wound healing assessment tool: A scoping review. Heliyon 2023; 9:e15736. [PMID: 37180932 PMCID: PMC10172750 DOI: 10.1016/j.heliyon.2023.e15736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/20/2023] [Accepted: 04/21/2023] [Indexed: 05/16/2023] Open
Abstract
Background Indonesia faces a challenge in controlling the burden of diabetic foot ulcers, which necessitates a nursing care management approach to optimize the healing of complications by accurately monitoring wound healing progress using wound assessment tools. Methods This literature review, which is part of a scoping study framework, searched electronic databases including PubMed, ScienceDirect, EBSCOhost, and Google Scholar to find papers relevant to the Indonesian context. Five papers were chosen from a total of 463 papers discovered. Results The diabetic foot ulcer wound assessment tools DFUAS (diabetic foot ulcer assessment scale), DMIST (deep, maceration, infection, size, and tunneling), and MUNGS (maceration, undermining, necrotic, granulation, and symptoms/signs) were identified in the literature review. For leg ulcers, LUMT (leg ulcer measurement tool) and RESVECH 2.0 (Results Expected from Chronic Wound Healing Assessment) were used. DMIST, DFUAS, and MUNGS are used to predict healed and non-healing wounds. LUMT determines the evaluation and documentation of leg ulcers, and RESVECH 2.0 is designed to shorten the duration of chronic wound occurrence. The psychometric properties of the DMIST scale were identified, including reliability, validity, and responsiveness. Conclusions Five tools for assessing chronic wounds were identified. The predictive validity and responsiveness of the DMIST tool were supported by a sufficient rating based on evidence quality. This scoping review provides an overview of the measurement properties of available assessment tools for diabetic foot ulcers.
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Affiliation(s)
- Suriadi Jais
- Corresponding author. Post Graduate School of Nursing, Institute of Technology and Health ,Muhammadiyah Pontianak, Jalan Sei Raya Dalam Gg Ceria V no 19 Kubu Raya, Pontianak, 78117, Indonesia.
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Abstract
Diabetic foot complications represent a substantial health burden and are the foremost cause of hospitalization in patients with diabetes. Diabetes mellitus (DM) is known to cause several other problems. Diabetes is rapidly becoming the leading cause of illness and death worldwide. Diabetic foot ulcers (DFU) are one of the most painful complications of diabetes. These complications cause problems in blood vessels, nerves, and other organs throughout the body. DFU pathophysiology is attributed to a triad of neuropathies, trauma with secondary infection, and arterial occlusive disease. This review aims to identify the types of wounds that diabetics can develop. Owing to the complexity of their disease pathology, diabetics are susceptible to a variety of wounds, such as diabetic ulcers due to trauma (DUDT); neuropathic, ischemic, neuroischemic, arterial, venous, and mixed wounds; and diabetic bullae, furuncles, cellulitis, and carbuncles. Therefore, it is essential for healthcare providers to recognize the specific classification of a diabetic wound based on its distinctive attributes to provide appropriate wound care and therapeutic interventions. In the context of individuals with diabetes, it is of paramount significance to precisely identify the types of wounds during the initial evaluation to provide appropriate care and treatment, thereby enhancing the probability of favorable outcomes.
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Affiliation(s)
- Suriadi Jais
- School of Nursing, The Institute of Technology and Health Muhammadiyah KALBAR, Pontianak, Indonesia
- Kitamura Wound Clinic, Pontianak, Indonesia
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Jais S, Pratama K, Pradika J, Haryanto H. The Validity and Efficacy of a Preventative Intervention Model for Reducing Ulcer Recurrence in Diabetic Patients in Indonesia. SAGE Open Nurs 2023; 9:23779608231179549. [PMID: 37334064 PMCID: PMC10272669 DOI: 10.1177/23779608231179549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 04/20/2023] [Accepted: 05/12/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction It is important to reduce foot problems by preventing the recurrence of ulcers in diabetes mellitus (DM) patients. In Indonesia, interventions for the prevention of ulcer recurrence remain scarce. Objective The present study aimed to evaluate the validity and efficacy of a proposed intervention model for preventing the recurrence of ulcers in DM patients. Method Sixty-four DM patients were selected to participate in this quasi-experimental study and divided into two groups: intervention (n = 32) and control (n = 32). The intervention group received preventive treatment while the control group received standard care. Two trained nurses supported this study. Results Of the 32 participants in the intervention group, 18 (56.20%) were male, 25 (78.10%) were non-smokers, 23 (71.90%) had neuropathy, 14 (43.80%) had foot deformities, four (12.50%) had recurring ulcers, and 20 (62.50%) had a previous ulcer < 12 months ago. Of the 32 participants in the control group, 17 (53.10%) were male, 26 (81.25%) were non-smokers, 17 (46.90%) had neuropathy, 19 (69.40%) had foot deformities, 12 (37.50%) had recurring ulcers, and 24 (75.00%) had a previous ulcer < 12 months ago. The mean (SD) age [62 (11.28) and 59 (11.11) years], ankle-brachial index [1.19 (0.24) and 1.11 (0.17)], HbA1C [9.18 (2.14%) and 8.91 (2.75%)], and DM duration [10.22 (6.71) and 10.13 (7.54)] of the intervention and control groups did not differ significantly. The content validity of the proposed intervention model was strong (I-CVI > 0.78). When the proposed screening tool for predicting the risk of ulcer recurrence in DM patients (NASFoHSkin) was used in the intervention group, its predictive validity, sensitivity, and specificity were 4, 100%, and 80%, respectively, while in the control group it was 4, 83%, and 80%, respectively. Conclusion Inspection/examination, foot care, and blood glucose control can decrease ulcer recurrence in DM patients.
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Affiliation(s)
- Suriadi Jais
- School of Nursing, The Institute of Technology and Health Muhammadiyah KALBAR, Pontianak, Indonesia
- Kitamura Wound Clinic, Pontianak, Indonesia
| | - Kharisma Pratama
- School of Nursing, The Institute of Technology and Health Muhammadiyah KALBAR, Pontianak, Indonesia
- Kitamura Wound Clinic, Pontianak, Indonesia
| | - Jaka Pradika
- School of Nursing, The Institute of Technology and Health Muhammadiyah KALBAR, Pontianak, Indonesia
- Kitamura Wound Clinic, Pontianak, Indonesia
| | - Haryanto Haryanto
- School of Nursing, The Institute of Technology and Health Muhammadiyah KALBAR, Pontianak, Indonesia
- Kitamura Wound Clinic, Pontianak, Indonesia
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Jais S, Pratama K, Fahrain J, Junaidi J, Kardiatun T, Kawuryan U. The SHID wound classification system for diabetic foot ulcer patients: a validity study. J Med Life 2022; 15:1224-1228. [DOI: 10.25122/jml-2022-0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 06/15/2022] [Indexed: 11/21/2022] Open
Abstract
This study aimed to evaluate the predictive validity of the SHID (Suriadi, Haryanto, Imran dan Defa) wound classification system compared to TU (Texas University) and Wagner wound classification systems in Indonesia. A prospective cohort study included patients with diabetic foot ulcers at Kitamura wound clinic in Indonesia. A total of 111 diabetic foot ulcer patients were assessed with SHID, TU, and Wagner wound classification systems. Two postgraduate nursing students assessed 111 wounds of bedside patients and observed them for 4 weeks. The predictive validity test indicated that the cut-off score of ≤grade 2 for SHID was 74% and 97%, ≤grade IB for TU was 77% and 92%, then ≤grade 2 for Wagner was 84% and 71% for sensitivity and specificity, respectively. The area under the curve (AUC) in SHID, TU, and Wagner tools was 0.90 (95% CI: 0.828–0.950), 0.85 (95% CI: I0.766–0.910), and 0.86 (95% CI: 0.775–0.917), respectively. The Youden index for SHID, TU, and Wagner was 0.72%, 0.70%, and 0.55%, respectively. The wound classification systems are good tools for identifying diabetic foot ulcers. However, the newly developed SHID tool produced the best AUC and Youden Index values compared to the Wagner tool.
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Astrada A, Nakagami G, Fajrianita I, Matsumoto M, Kawamoto A, Jais S, Sanada H. Ultrasonographic features of diabetic foot osteomyelitis: a case series. J Wound Care 2022; 31:748-754. [PMID: 36113548 DOI: 10.12968/jowc.2022.31.9.748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Osteomyelitis is a limb-threatening complication of diabetic foot ulcers. Early identification of the disease is key to ensuring successful prognosis. In this study, we describe ultrasonographic features for the identification of osteomyelitis. METHOD Patients were screened through clinical, ultrasonographic and probe-to-bone tests. RESULTS Ultrasonographic features in three patients that could be used to identify diabetic foot osteomyelitis included periosteal reaction, periosteal elevation, cortical erosions and presence of sequestrum, all of which were confirmed by a plain X-ray. CONCLUSION An ultrasonographic examination could be used for the early detection of osteomyelitis, which could help clinicians devise prompt treatment strategies.
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Affiliation(s)
- Adam Astrada
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, the University of Tokyo, Japan.,Department of Midwifery, 'Aisyiyah Polytechnics Pontianak, Indonesia.,Komamura Wound Center, Indonesia
| | - Gojiro Nakagami
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, the University of Tokyo, Japan.,Division of Care Innovation, Global Nursing Research Center, the University of Tokyo, Japan
| | - Indria Fajrianita
- Department of Diagnostic Radiology, Tanjungpura University Hospital, Indonesia
| | | | - Atsuo Kawamoto
- Division of Ultrasound and Department of Diagnostic Imaging, Tokyo Medical University Hospital, Japan
| | - Suriadi Jais
- Department of Post-Graduate Nursing Program, Institute of Nursing Muhammadiyah Pontianak, Indonesia.,Kitamura Clinic, Pontianak, Indonesia
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Haryanto H, Jais S, Supriadi S, Imran I, Ogai K, Oe M, Okuwa M, Sugama J. Correlation Between Bacteria Count Using a Rapid Bacterium Counting System and Changes in Wound Area on Diabetic Foot Ulcers in Indonesia: A Prospective Study. INT J LOW EXTR WOUND 2022:15347346221098515. [PMID: 35521915 DOI: 10.1177/15347346221098515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to clarify the correlation between changes in bacterial number and wound area in diabetic foot ulcers (DFUs). This study used a prospective longitudinal cohort design. A total of 30 participants met the inclusion criteria. Changes in bacterial number and wound area were evaluated weekly until week 4. The chi-square test indicated no significant correlation between biofilm formation and wound area (p = 0.32) but a significant correlation between bacterial count and wound area (p = 0.05). Logistic regression analysis showed a significant correlation between bacterial count and changes in wound area (odds ratio, 0.60; 95% confidence interval [CI], 0.372-0.997; p = 0.04). The receiver operating characteristic analysis showed an area under the curve of 0.660 (95% CI, 0.52-0.79; p = 0.03) with a sensitivity of 97% and specificity of 88%. The present prospective longitudinal cohort study demonstrated the correlation between bacterial count changes and wound area in DFUs. Our results suggest that changes in bacterial count could help wound healing evaluations.
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Affiliation(s)
- Haryanto Haryanto
- 184383The Institute of Nursing Muhammadiyah/STIK Muhammadiyah, Pontianak, Indonesia
| | - Suriadi Jais
- 184383The Institute of Nursing Muhammadiyah/STIK Muhammadiyah, Pontianak, Indonesia
| | - Supriadi Supriadi
- Graduate Course of Nursing Sciences, Division of Health Sciences, 12858Kanazawa University, Japan
| | - Imran Imran
- Graduate Course of Nursing Sciences, Division of Health Sciences, 12858Kanazawa University, Japan
| | - Kazuhiro Ogai
- Department of Clinical Nursing, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Japan
| | - Makoto Oe
- Department of Clinical Nursing, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Japan
| | - Mayumi Okuwa
- Department of Clinical Nursing, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Japan
| | - Junko Sugama
- Advanced Health Care Science Research Unit, Innovative Integrated Bio-Research Core, Institute for Frontier Science Initiative, Kanazawa University, Japan
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Abstract
Many studies have shown that honey might improve wound healing. However, its efficacy for large wounds which may be followed by a systemic effect remains unclear. The effectiveness of honey-based dressings in treating large diabetic foot ulcers (DFU) is still unknown. This study presents the case of a 38-year-old female patient presenting with an extensive infected DFU with exposed bone. The DFU was treated with propolis-enriched Trigona honey, used as a single treatment, in a home visit setting. After two months' follow-up, the wound exhibited complete re-epithelialisation despite the patient's initial poor condition.
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Affiliation(s)
- Adam Astrada
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, the University of Tokyo, Japan
- BantuMelangkah.com
| | - Gojiro Nakagami
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, the University of Tokyo, Japan
- Global Nursing Research Center, Graduate School of Medicine, the University of Tokyo, Japan
| | - Suriadi Jais
- Kitamura Clinic, Indonesia
- Muhammadiyah Institute of Nursing Science, Pontianak, Indonesia
| | - Hiromi Sanada
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, the University of Tokyo, Japan
- Global Nursing Research Center, Graduate School of Medicine, the University of Tokyo, Japan
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