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Abstrak :
Diperkirakan sekitar 15% penderita diabetes akan mengalami diabetic foot ulcer (DFU). Negative Pressure Wound Therapy (NPWT) terbukti lebih efektif dibandingkan dengan perawatan konvensional. Penelitian ini dilakukan untuk mengetahui faktor risiko yang memengaruhi lama rawat DFU dengan NPWT. Penelitian ini merupakan studi retrospektif dengan desain cross sectional analitik pada 105 subjek yang dirawat pada Januari 2016 sampai Desember 2018 di RS dr. Cipto Mangunkusumo. Lama rawat DFU dengan NPWT adalah 19,9 ± 19,3 hari. Faktor risiko yang mempengaruhi lama rawat adalah riwayat ulkus (r = 0,01; p = 0,034), kedalaman luka (r = 0,292; p = 0.003), Hb (r = 0,05; p = 0,039), HbA1c (r = 0,06; p = 0,033), albumin (r = 0,06; p = 0,017), PCT (r = 0,10; p = 0,035), dan lama menderita DM (r = 0,193; p = 0,009). Penelitian ini menunjukkan bahwa lama rawat DFU dengan NPWT dipengaruhi oleh faktor sitemik (lama menderita DM, Hb, HbA1c, albumin, dan PCT) dan faktor lokal (riwayat ulkus sebelumnya dan kedalaman luka). Kedalaman luka merupakan faktor yang paling berhubungan positif terhadap lama perawatan DFU pasca NPWT (r = 0,292, p = 0,003). Intervensi pada faktor risiko patut dilakukan untuk memaksimalkan penggunaan NPWT dan mengurangi lama perawatan. ......It is estimated that around 15% of diabetic patients will experience diabetic foot ulcer (DFU). Negative Pressure Wound Therapy (NPWT) is proven to be more effective than conventional treatments. This study was conducted to determine the risk factors that affect the length of stay of DFU with NPWT. This research is a retrospective study with a cross-sectional analytic design of 105 subjects treated in January 2016 to December 2018 at dr. Cipto Mangunkusumo Hospital. The average length of stay of DFU with NPWT was 19.9 ± 19.3 days. Risk factors affecting the length of stay were history of ulcers (r = 0.01; p = 0.034), wound depth (r = 0.292; p = 0.003), Hb (r = 0.05; p = 0.039), HbA1c (r = 0.06; p = 0.033), albumin (r = 0.06; p = 0.017), PCT (r = 0.10; p = 0.035), and duration of DM (r = 0.193; p = 0.009). This study showed that the length of stay of DFU with NPWT was influenced by systemic factors (duration of DM, Hb, HbA1c, albumin, and PCT) and local factors (history of previous ulcers and wound depth). Depth of the wound was themost positively related factor to the length of stay in DFU post NPWT (r = 0.292; p = 0.003). Interventions on the risk factors may amplify the result of NPWT and reduce the length of treatment.

Abstrak :
Latar Belakang: DM merupakan salah satu penyebab morbiditas dan mortalitas tertinggi di dunia, dengan 15-25% pasien akan berkomplikasi menjadi DFU. Data pada tahun 2003 di RSCM menunjukkan bahwa angka kematian akibat DFU adalah 16% dan angka amputasi mencapai 25%. Hingga saat ini belum terdapat strategi tatalaksana DFU yang efektif karena patogenesis molekular yang menyebabkan kegagalan penyembuhan luka masih belum sepenuhnya dipahami. Selain itu pengendalian kadar glukosa darah dalam pengobatan DFU masih belum jelas dan menjadi perdebatan dalam berbagai studi. Tujuan: Penelitian ini bertujuan untuk menganalisis hubungan HbA1c dan GDS dengan faktor angiogenesis HIF-1α, sehingga dapat dijadikan dasar dalam melakukan tata laksana yang tepat untuk pasien DFU. Metode: Desain penelitian potong lintang. Subjek penelitian pasien DFU yang berobat ke RSCM, diambil data dasar (jenis kelamin dan usia), pemeriksaan klinis (TB, BB, dan IMT), pemeriksaan laboratorium (GDS, HbA1c). HIF-1α diperiksa dari sampel biopsi jaringan luka DFU saat operasi debridemen dan amputasi dengan pemeriksaan ELISA. Data dilakukan uji normalitas Saphiro-Wilk dan uji normalitas Kolmogorov Smirnov, dilanjutkan uji korelasi Spearman. Pengaruh variabel perancu dianalisa dengan uji mann whitney dan tes regresi linear sederhana. Hasil: Terdapat 64 pasien yang memenuhi kriteria inklusi dan dilakukan pemeriksaan kadar HiF1α dari sampel jaringan biopsi. Data karakteristik didapatkan hasil kelompok dominan perempuan (54.7%) dengan usia rerata 55.7 ± 10.4 tahun, IMT median 24.9 kg/m² (overweight 48.2%, obesitas 34.6%), dan komorbid anemia (84.3%). Karakteristik laboratorium, GDS median 220 (14-705)mg/dL dengan kelompok kondisi hiperglikemik >200 mg/dL sebanyak 54.7%. HbA1c median 7.7(4.1-13.7)% dengan kelompok kontrol gula darah buruk HbA1c >6.5% sebanyak 85.8%. Tidak didapatkan korelasi bermakna antara GDS dengan HIF-1α p 0.523(p>0.05). Tidak didapatkan korelasi yang bermakna antara HbA1c dengan HIF-1α p 0.792(p>0.05). Didapatkan variable perancu yang bermakna pada kondisi derajat luka DFU p 0.03 (p< 0,05). Kesimpulan: Hasil penelitian ini menunjukkan bahwa baik HbA1c atau GDS tidak mempunyai hubungan yang bermakna dengan kadar HiF-1α. Variabel perancu kondisi derajat luka DFU berpengaruh secara signifikan terhadap ekspresi HIF-1α ......Background: DM is one of the leading causes of morbidity and mortality in the world, with 15-25% of patients developing complications of DFU. Results data in 2003 at the RSCM showed that the mortality rate from DFU was 16% and the amputation rate was 25%. There is no effective DFU management strategy because the molecular pathogenesis that causes wound healing failure is still not fully understood. In addition, the control of blood glucose levels in the treatment of DFU is still unclear and has been debated in various studies. Objective: This study aims to analyze the relationship between HbA1c and GDS with the angiogenesis factor HIF-1α, so that it can be used as a basis for appropriate management of DFU patients. Methods: The research design was cross sectional. Body mass index, comorbid disease status were recorded. The laboratory parameters GDS, HbA1c and HiF-1a expression examined in the laboratory. Test the normality data by the Saphiro-Wilk test and the Kolmogorov Smirnov test, followed by the Spearman correlation test. The effect of confounding variables was analyzed by Mann Whitney test and simple linear regression test. Results: There were 64 patients who met the inclusion criteria and were examined for HiF1α levels from biopsy tissue samples. Characteristic data showed that the dominant group was female (54.7%) with a mean age of 55.7 ± 10.4 years, median BMI 24.9 kg/m² (overweight 48.2%, obesity 34.6%), and comorbid anemia (84.3%). Laboratory characteristics, the median GDS of 220 (14-705)mg/dL with the hyperglycemic condition group >200 mg/dL as much as 54.7%. The median HbA1c was 7.7(4.1-13.7)% with the bad blood sugar control group HbA1c >6.5% as much as 85.8%. There was no significant correlation between GDS and HIF-1α p 0.523 (p>0.05). There was no significant correlation between HbA1c and HIF-1α p 0.792 (p>0.05). A significant confounding variable was found in the condition of the degree of wound DFU p 0.03 (p < 0.05). Conclusion:The results of this study showed that neither HbA1c nor GDS had a significant correlation with HiF-1α . The confounding variable of DFU wound degree had a significant effect on the expression of HIF-1α

Abstrak :
Latar Belakang: Faktor resiko terbesar Diabetik foot ulcer DFU adalah neuropati. Gen Vascular endothelial growth factor VEGF 7 merupakan gen yang mengkode protein Vascular Endothelial Growth Factor VEGF memiliki fungsi angiogenesis dan neurogenesis. VEGF berperan pada patogenesis terjadinya neuropati, angiopati dan penyembuhan luka karena trauma. Metode Penelitian: Penelitian case control study, kasus diambil dari penderita DM tipe 2 dengan DFU dan kontrol dari DM tipe 2 tanpa DFU, dilakukan Polimerase Chain Reaction Restriction Fracment lenght Polymorphism PCR-RFLP untuk melihat genotipe gen VEGF, analisis statistik menggunakan SPSS 20. Hasil: Genotip mutan GG gen VEGF 405C>G tidak memiliki hubungan bermakna dengan terjadinya DFU pada penderita DM di RSCM GG CG/CC ; OR; 0,52, 95 CI; 0,15-1,73 p; 0,289. Alel G; kemungkinan sebagai faktor protektif OR;0,86, 95 CI 0,57-1,28 dan p;0,456. Genotip mutan TT gen VEGF -460 C>T; tidak memiliki hubungan yang bermana dengan DFU TT CT/CC ; OR; 0,97, 95 CI; 0,41-2,26 dan p; 0,942. Alel T kemungkinan sebagai faktor protektif OR;0,90, 95 CI; 0,59-1,37 dan p;0,641. Kesimpulan: Genotip GG dan TT tidak memiliki hubungan yang bermakna dengan penyakit DFU, alel G dan alel T kemungkinan sebagai faktor protektif terhadap terjadinya DFU pada penderita DM Tipe 2.

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Background: The greatest risk factor for Diabetic foot ulcer DFU is neuropathy. Vascular endothelial growth factor VEGF gene is a gene encodes a protein vascular endothelial growth factor VEGF, which has function of angiogenesis and neurogenesis. VEGF play a role in neuropathy, angiopathy and wound healing in DFU. Methods: Case control study, case is type 2 DM with DFU and control is type 2 DM without DFU, Polymerase Chain Reaction Restriction Fracment lenght polymorphism was done to find genotype polymorphism of VEGF gene. Results: Genotype GG VEGF 405C G does not have a significan association with DFU in DM patients GG CG CC OR 0.52, 95 CI 0.15 to 1.73 p 0.289. G allele is proposed as protective factor in DFU OR 0.86, 95 CI 0.57 to 1.28, and p 0.456. Genotype TT from VEGF gene 460 C T have no significant association with DFU TT CT CC OR 0.97, 95 CI 0.41 to 2.26 and p 0.942. T allele is predicted as protective factor in DFU OR 0.90, 95 CI 0.59 to 1.37 and p 0,641. Conclusion: G alles and T alleles are predicted as a protective factors in DM patients associated with DFU.

Abstrak :
Objektif: Diabetic Foot Ulcer DFU merupakan komplikasi Diabetes Mellitus Tipe 2 DMT2 yang dapat berujung pada disabilitas dan kematian. Kondisi vaskularisasi yang tidakadekuat dapat mempengaruhi proses penyembuhan pada DFU. Studi terbarumenunjukkan TGF-?1 mempunyai peran dalam proses penyembuhan luka danmenghasilkan neuropati, penyebab utama terjadinya DFU. Oleh sebab itu, studi inimelakukan investigasi terhadap ekspresi dari polimorfisme TGF-β1 dalam hubungannyapada kejadian DFU pada DMT2. Metode: Penelitian ini menggunakan studi kasus kontrol untuk membandingkan polimorfismeTGF-?1 gen 1800469 C>T dan gen 1982073 C>T pada DMT2 di RS CiptoMangunkusumo RSCM Jakarta Juni hingga Desember 2016. Teknik PCR digunakanuntuk membandingkan hasilnya pada grup DMT2 dengan DFU dan DMT2 tanpa DFU. Hasil: Terdapat 197 pasien secara keseluruhan yang terbagi atas 96 pasien dengan DFU dan 101pasien kontrol grup tanpa DFU. Distribusi allel dari TGF- ?1 1800469 C>T adalah 54,3 dan T 45,7 , sedangkan distribusi TGF-β1 1982073 C>T adalah C 72,3 dan T 27,7 .Dengan kata lain, polimorfisme TGF-β1 mempunyai peran dalam pembentukan danproses penyembuhan DFU pada pasien DMT2. Kesimpulan: Didapatkan hubungan bermakna pada gen RS1982073 sebagai factor pencegah danRS1800469 sebagai factor resiko terjadinya DFU.

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Objective: Diabetic Foot Ulcer DFU is one of the complication of Type 2 Diabetes Mellitus T2DM that can lead to disability and death. Inadequate vascularization condition willaffect healing process of DFU. Recent study showed, TGF 1 has a role in the processof wound healing and process of resulting neuropathy, the most common cause of DFU.Therefore, we investigated the expression of polymorphism TGF 1 in relation of theoccurance of DFU in T2DM. Methods: We designed a case control study to investigate the polymorphism TGFβ1 gene1800469 C T and 1982073 C T in T2DM in Cipto Mangunkusumo National Hospital RSCM Jakarta from june to December 2016. We used PCR techniques and comparedthe results in group of T2DM patients with DFU as the case study and without DFU asthe control group. Results: There were 197 patients, 96 patients with DFU and 101 patients control without DFU.49,8 is male and 50,2 female with mean age about 56 years. Distribution of wildtype genotype TGFβ1 1800469 C T wild type CC were found in 44,8, the number ofmutant heterozygote CT was 10,8 and mutant homozygote is 11,3. Distribution ofTGF B1 1982073 C T wild type CC was 32,5, mutant heterozygote is 38,9 andmutant homozygote 25,1. Conclusion: Were found meaning relationship in gene RS1982073 as inhibitor factor and geneRS1800469 as risk factor of the DFU in T2DM patients.

Abstrak :
Latar belakang: Diperkirakan sekitar 15% penderita diabetes akan mengalami diabetic foot ulcer (DFU) dalam masa hidupnya. Negative Pressure Wound Therapy (NPWT) terbukti lebih efektif dibandingkan dengan perawatan konvensional. NPWT menciptakan lingkungan luka yang lembab, peningkatan aliran darah lokal dan merangsang jaringan granulasi sehingga mempercepat penyembuhan luka. Penelitian ini dilakukan untuk mengetahui faktor risiko yang memengaruhi lama rawat DFU dengan NPWT. Metode Penelitian: Penelitian ini merupakan studi retrospektif dengan desain cross sectional analitik pada 105 subjek yang dirawat pada Januari 2016 sampai Desember 2018 di RS dr. Cipto Mangunkusumo. Karakteristik dan demografi pasien dan faktor risiko diambil dari rekam medik. Durasi perawatan dari aplikasi pertama NPWT hingga luaran sebagai hasil, kemudian dianalisis terhadap faktor risiko yang memengaruhinya. Hasil Penelitian: Lama rawat DFU dengan NPWT adalah 19,9 ± 19,3 hari. Faktor risiko yang mempengaruhi lama rawat adalah riwayat ulkus (r = 0,01; p = 0,034), kedalaman luka (r = 0,292; p = 0.003), Hb (r = 0,05; p = 0,039), HbA1c (r = 0,06; p = 0,033), albumin (r = 0,06; p = 0,017), PCT (r = 0,10; p = 0,035), dan lama menderita DM (r = 0,193; p = 0,009). Kesimpulan: Penelitian ini menunjukkan bahwa lama rawat DFU dengan NPWT dipengaruhi oleh faktor sitemik (lama menderita DM, Hb, HbA1c, albumin, dan PCT) dan faktor lokal (riwayat ulkus sebelumnya dan kedalaman luka). Kedalaman luka merupakan faktor yang paling berhubungan positif terhadap lama perawatan DFU pasca NPWT (r = 0,292, p = 0,003). Intervensi pada faktor risiko yang dapat diperbaiki sebelum penggunaan NPWT patut dilakukan untuk memaksimalkan penggunaan NPWT dan mengurangi lama perawatan. ......Background: It is estimated that around 15% of diabetic patients will experience diabetic foot ulcer (DFU) in their lifetime. Negative Pressure Wound Therapy (NPWT) is proven to be more effective than conventional treatments. NPWT creates a moist wound environment, increases local blood flow and stimulates tissue granulation thereby accelerating wound healing. This study was conducted to determine the risk factors that affect the length of stay of DFU with NPWT. Knowing this risk factors may be helpful for optimizing management strategy. Methods: This research is a retrospective study with a cross-sectional analytic design in 105 subjects treated in January 2016 to December 2018 at RS. dr. Cipto Mangunkusumo. Patient characteristics, demographics and risk factors were taken from medical records. The length of stay of the patient from the first application of NPWT to its outcomes was the main result, then the correlation to the risk factors that influence it was analyzed. Results: The length of stay of DFU with NPWT was 19.9 ± 19.3 days. Risk factors affecting the length of stay were history of ulcers (r = 0.01; p = 0.034), wound depth (r = 0.292; p = 0.003), Hb (r = 0.05; p = 0.039), HbA1c (r = 0.06; p = 0.033), albumin (r = 0.06; p = 0.017), PCT (r = 0.10; p = 0.035), and duration of DM (r = 0.193; p = 0.009). Conclusions: This study showed that the length of stay of DFU with NPWT was influenced by systemic factors (duration of DM, Hb, HbA1c, albumin, and PCT) and local factors (history of previous ulcers and wound depth). The depth of the wound was the most positively related factor to the length of stay in DFU post NPWT (r = 0.292; p = 0.003). Interventions on the risk factors that can be corrected before the application of NPWT may amplify the result of NPWT and reduce the length of treatment.

Abstrak :
Introduction: Diabetes mellitus can cause various complications, including diabetic foot ulcers (DFU). Vitamin D levels are known to be correlated with wound healing and insulin resistance. Method: This cross-sectional study aimed to determine the correlation between the serum level of vitamin D and the severity degree of DFU. Thirty DFU patients with normal ankle- brachial index, grouped into degrees according to the Wagner classification, were included in this study. Their serum level of vitamin D was examined using the chemiluminescent immunoassay method. The correlation between these two variables was analyzed. Results: Patients were 18 males (60%) and 12 females (40%) with an average age of 57 years. The average serum level of vitamin D was 10.58 ng/mL. A significant correlation was found between the serum level of vitamin D and the severity of DFU (r= -0.901, p <0.001).

Abstrak :
ABSTRAK
Latar Belakang. Ulkus Kaki Diabetik DFU adalah salah satu komplikasi dari Diabetes Mellitus, saat ini cenderung meningkat di seluruh dunia, khususnya di Jakarta, Indonesia. Beberapa penelitian mengindikasikan polimorfisme gen matrix metalloproteinases-9 MMP9 pada titik -1652C/T dan 836 A/G memiliki peranan penting dalam perkembangan dan patofisiologi Ulkus kaki diabetik yakni sebagai penanda inflamasi. Namun belum ada penelitian yang spesifik meneliti tentang MMP9 dalam hubungannya dengan DFU di Jakarta. Tujuan dari penelitian ini adalah mengetahui hubungan polimorfisme gen MMP9 dengan penyakit ulkus diabetik pada penderita Diabetes melitus tipe 2 di RSUPN Dr. Cipto Mangunkusumo Jakarta, Indonesia.Metode Penelitian. Penelitian ini menggunakan case control study, subjek penelitian adalah semua penderita DM tipe 2 dengan atau tanpa DFU yang memenuhi kriteria inklusi dan berkunjung ke RSUPN Dr. Cipto Mangunkusumo pada bulan juli 2016-Desember 2016. Data demografi, klinis, laboratorium, distribusi genotip dan distribusi alel dicatat serta peneliti mencari hubungan antara Polimorfisme gen MMP9 dengan penyakit ulkus pada penderita Diabetes Mellitus tipe 2.Hasil Penelitian. Terdapat seratus sembilan puluh tujuh pasien diabetes mellitus tipe dua laki-laki = 49,2 , dan perempuan = 50,8 . Faktor yang berpengaruh dan bermakna secara statistik yakni PAD p=0,001 , Nyeri Istirahat p=0,001 , Neuropati p=0,001 , Merokok p=0,001 , Hipertensi p=0,001 , Anemia p=0,001 , Leukositosis p=0,001 . Pada uji bivariat, diketahui Pada MMP9 -1562C>T, Genotip TC memiliki perbedaan secara signifikan secara statistik, dan merupakan faktor pencegah dalam terjadinya DFU p=0,001 .Kesimpulan. Distribusi Alel Polimorfisme gen -1562C/T pada seluruh populasi, pada alel C = 74,6 , Alel T = 25,4 . Distribusi Alel Polimorfisme gen 836A/G, pada alel A = 41,4 , dan Alel G = 58,6 pada seluruh populasi. Diketahui Pada MMP9 -1562C>T, Genotip TC memiliki perbedaan secara signifikan secara statistik, dan merupakan faktor pencegah dalam terjadinya DFU p=0,001 di RSUPN Cipto Mangunkusumo, Jakarta, Indonesia.

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ABSTRACT
Objectives. Diabetic Foot ulcer DFU as Diabetes complication, is increasing worldwide especially in Jakarta, Indonesia. Several studies indicated that matrix metalloproteinases 9 MMP9 play key roles in the progression of Diabetic Foot Ulcer as an important inflammatory marker involved in the pathophysiology of DFU. But there is no study specifically examining MMP9 associated with DFU in Jakarta. The aim of this study to analyze MMP9 gene polymorphism associated with DFU patients in Ciptomangunkusumo National General Hospital.Methods. This case control study included 197 patients diagnosed with T2DM with or without DFU as complication at the Ciptomangunkusumo National General Hospital between August 2016 and December 2016. Demography, Clinical, Laboratorium findings, Genotype distribution, Allel distribution, and Analysis Of Matrix Metalloprotein 9 Mmp 9 Gene Polymorphism Associated With Diabetic Foot Ulcer In Tipe 2 Diabetes Collected.Results. There are one hundred and ninty seven patiens with type 2 diabetes mellitus men 49,2 , women 50,8 . Factor that influence and statistically significant are PAD p 0,001 , Rest Pain p 0,001 , Neuropathy p 0,001 , Smoking p 0,001 , Hypertension p 0,001 , Anemia p 0,001 , Leucositosis p 0,001 . According to bivariat study, Found that MMP9 1562C T, Genotype TC have significant differential in statistic, and has protective factor p 0,001 .Conclusion. Alel distribution in DM type 2 Alel C 74,6 , Alel T 25,4 , Alel A 41,4 , Alel G 58,6 . Found in MMP9 1562C T, Genotype TC have significant differential in statistic, and has protective factor p 0,001 .

Abstrak :
Latar Belakang: Tindakan revaskularisasi menjadi hal yang penting dalam penyembuhan ulkus kaki diabetikum dengan penyakit arteri perifer, karena berperan dalam merestorasi fungsi perfusi jaringan tungkai. Selain itu, beberapa studi juga melaporkan bahwa tindakan ini juga dapat mengurangi risiko komplikasi kardiovaskular. Namun, belum ada penelitian di Indonesia yang secara ekslusif membahas efektivitas revaskularisasi pada pasien ulkus kaki diabetik dengan penyakit arteri perifer. Tujuan penelitian ini adalah membandingkan tingkat kesembuhan ulkus kaki diabetik dengan penyakit arteri perifer terhadap pasien yang dilakukan revaskularisasi maupun yang tidak dilakukan revaskularisasi. Metode: Penelitian ini berlangsung dari Januari hingga Mei 2023, di RSUPN Cipto Mangunkusumo, dengan desain kohort retrospektif. Hasil: Jumlah sampel pada masing-masing tindakan adalah 23 pasien. Tingkat kesembuhan pasien ulkus kaki diabetik dengan penyakit arteri perifer yang mendapatkan tindakan revaskularisasi adalah 78,3% (18 pasien), sementara yang tidak mendapatkan tindakan revaskularisasi 26,1% (6 pasien). Pasien yang menjalani tindakan revaskularisasi memiliki peluang 14,944 (1,102–202,692) kali lebih tinggi untuk mengalami kesembuhan luka dibandingkan pasien ulkus kaki diabetik dengan penyakit arteri perifer yang tidak mendapatkan tindakan revaskularisasi (p < 0,01). Setelah mengontrol faktor perancu, tindakan revaskularisasi tetap ditemukan berpengaruh terhadap kesembuhan pasien dengan WIfI stadium 2-3 memiliki peluang 11,926 (1,438–98,883) untuk mengalami penyembuhan luka dibandingkan pasien dengan WIfI stadium 4. Kesimpulan: Tingkat kesembuhan pasien revaskularisasi lebih tinggi dibandingkan non-revaskularisasi. Selain itu, keparahan luka berdasarkan WIfI juga berpengaruh pada kesembuhan luka pasien. ......Background: Revascularization is important in the healing of diabetic foot ulcers with peripheral arterial disease, because it plays a role in restoring the perfusion function of the leg tissues. In addition, several studies also report that this action can also reduce the risk of cardiovascular complications. However, there is no study in Indonesia that exclusively discusses the effectiveness of revascularization in diabetic foot ulcer patients with peripheral arterial disease. This study aims to compare the healing rates of diabetic foot ulcers with peripheral arterial disease in patients who underwent revascularization and those who did not undergo revascularization. Methods: This study was conducted from January to May 2023, at Cipto Mangunkusumo General Hospital, with a retrospective cohort design. Results: The number of samples in each group was 23 patients. The healing rate for diabetic foot ulcer patients with peripheral arterial disease who received revascularization was 78.3% (18 patients), while those who did not receive revascularization was 26.1% (6 patients). Patients who underwent revascularization had a 14.944 (1.102–202.692) times higher chance of getting their wound healed than patients with diabetic foot ulcers with peripheral arterial disease who did not receive revascularization (p <0.01). After controlling for confounding factors, revascularization was still found to have an effect on healing. Patients with WIfI stage 2-3 had a 11,926 (1,438–98,883) chance of experiencing wound healing compared to patients with stage 4 WIfI. Conclusion: The wound healing rate for revascularized patients is higher than non-revascularized patients. In addition, the severity of the wound based on WIfI score also affects the patient's wound healing.

Abstrak :
Ulkus diabetikum merupakan salah satu komplikasi yang sering terjadi pada pasien diabetes mellitus. Ulkus diabetikum tidak hanya menyebabkan ketidaknyamanan fisik tetapi juga menyebabkan ketidaknyamanan psikologis berupa stres. Penelitian ini bertujuan untuk mengidentifikasi hubungan antara strategi koping dengan tingkat stres pada pasien ulkus diabetikum di Rumah Perawatan Luka RUMAT . Jenis penelitian ini adalah kuantitatif dengan desain cross-sectional, pengambilan sampel menggunakan metode purposive sampling sejumlah 93 responden pasien ulkus diabetikum . Sebanyak 93 pasien ulkus diabetikum diwawancarai dengan menggunakan Brief COPE untuk mengukur strategi koping dan Perceived Stress Scale untuk mengukur stres, kemudian dianalisis menggunakan uji t-independen. Hasil penelitian ini didapatkan bahwa terdapat hubungan yang bermakna antara emotion-focused coping dan stres p: 0,003, ?: 0,05 namun tidak terdapat hubungan bermakna antara problem-focused coping dengan stres p: 0,996; ?: 0,05. Penelitian ini merekomendasikan perlunya penelitian lanjutan terkait aspek psikologis pasien ulkus diabetikum. ......Diabetic ulcer is one of the complications that occurs among diabetic patients. It caused physical discomfort and also psychological discomfort stress. This study aimed to identify correlation between coping strategy and stress on diabetic ulcer patients in RUMAT Wound Care. This research was quantitative with cross sectional design, using purposive sampling with 93 respondents. Total of 93 diabetic ulcer patients were interviewed using Brief COPE to measure coping strategies and Perceived Stress Scale to measure stress, then analyzed by independent t test. Results of this study found that there were significant correlation between emotion focused coping and stress p 0,003, 0,05 while there were no correlation between problem focused coping and stress p 0,996, 0,05 . This study recommended further research on psychological aspects of diabetic ulcer patients.

Abstrak :
ABSTRAK
Ulkus kaki diabetik mengakibatkan mortalitas yang semakin meningkat terutama pasca amputasi, beban yang signifikan pada pembiayaan kesehatan dan menyebabkan hilangnya produktivitas. Penelitian ini bertujuan untuk mengetahui efektivitas terapi kombinasi dari laserpunktur dan perawatan luka konvensional dibandingkan dengan laserpunktur sham dan perawatan luka konvensional terhadap penyembuhan ulkus kaki diabetik. Uji klinis acak tersamar ganda dengan pembanding dilakukan terhadap 36 pasien yang dialokasikan ke dalam kelompok kasus atau kelompok kontrol. Tindakan laserpunktur dilakukan pada titik LI4 Hegu, ST36 Zusanli, SP6 Sanyinjiao, dan KI3 Taixi bilateral serta penyinaran pada ulkus dua kali seminggu, selama empat minggu. Rerata ukuran ulkus kaki diabetik sebagai keluaran primer diukur setiap minggu. Hasil penelitian menunjukkan perbedaan yang bermakna antara penurunan luas luka akhir di kelompok laserpunktur dan perawatan luka konvensional dengan kelompok laserpunktur sham dan perawatan luka konvensional (p=0,006). Dapat disimpulkan bahwa terapi kombinasi laserpunktur dan perawatan luka konvensional efektif mempercepat penyembuhan ulkus kaki diabetik dengan frekuensi terapi dua kali seminggu. ABSTRACT
Diabetic foot ulcers result in mortality is increasing, especially after the amputation, a significant burden on health financing and lead to loss of productivity. This study aims to determine the effectiveness of the combination therapy between laserpuncture and conventional wound care compared with sham laserpuncture and conventional wound treatment for healing diabetic foot ulcers. Double-blind randomized clinical trial with a control carried out on 36 patients allocated to the case group or control group. Laserpuncture actions performed on LI4 point Hegu, Zusanli ST36, SP6 Sanyinjiao and Taixi KI3 bilateral as well as exposure to ulcers twice a week, for four weeks. The mean size of diabetic foot ulcers as the primary output is measured every week. The results showed a significant difference between the reduction in wound area at the end of the group laserpuncture and conventional wound care compare with laserpuncture sham group and conventional wound treatment (p = 0.006). It can be concluded that the combination therapy laserpuncture and conventional wound care effectively accelerate the healing of diabetic foot ulcers with frequency therapy twice a week.;Diabetic foot ulcers result in mortality is increasing, especially after the amputation, a significant burden on health financing and lead to loss of productivity. This study aims to determine the effectiveness of the combination therapy between laserpuncture and conventional wound care compared with sham laserpuncture and conventional wound treatment for healing diabetic foot ulcers. Double-blind randomized clinical trial with a control carried out on 36 patients allocated to the case group or control group. Laserpuncture actions performed on LI4 point Hegu, Zusanli ST36, SP6 Sanyinjiao and Taixi KI3 bilateral as well as exposure to ulcers twice a week, for four weeks. The mean size of diabetic foot ulcers as the primary output is measured every week. The results showed a significant difference between the reduction in wound area at the end of the group laserpuncture and conventional wound care compare with laserpuncture sham group and conventional wound treatment (p = 0.006). It can be concluded that the combination therapy laserpuncture and conventional wound care effectively accelerate the healing of diabetic foot ulcers with frequency therapy twice a week.;Diabetic foot ulcers result in mortality is increasing, especially after the amputation, a significant burden on health financing and lead to loss of productivity. This study aims to determine the effectiveness of the combination therapy between laserpuncture and conventional wound care compared with sham laserpuncture and conventional wound treatment for healing diabetic foot ulcers. Double-blind randomized clinical trial with a control carried out on 36 patients allocated to the case group or control group. Laserpuncture actions performed on LI4 point Hegu, Zusanli ST36, SP6 Sanyinjiao and Taixi KI3 bilateral as well as exposure to ulcers twice a week, for four weeks. The mean size of diabetic foot ulcers as the primary output is measured every week. The results showed a significant difference between the reduction in wound area at the end of the group laserpuncture and conventional wound care compare with laserpuncture sham group and conventional wound treatment (p = 0.006). It can be concluded that the combination therapy laserpuncture and conventional wound care effectively accelerate the healing of diabetic foot ulcers with frequency therapy twice a week.