ABSTRAK
Luka kaki diabetik (LKD) merupakan komplikasi kronik diabetes yang meningkatkan mortalitas danmorbiditas, serta menurunkan kualitas hidup. Komplikasi makro dan mikrovaskular/mikrosirkulasimempunyai pengaruh besar terhadap kejadian LKD dan proses penyembuhannya. Kondisimikrosirkulasi dapat dinilai melalui pemeriksaan transcutaneous perfusion oxygen (TcPO2). Kondisimikrosirkulasi dipengaruhi oleh HbA1c, glukosa darah sewaktu, neuropati, fibrinogen, PAI-1,hsCRP, indeks MMP-9, indeks TcPO2, dan indeks TcPCO2, yang akan memengaruhi terbentuknyajaringan granulasi.Penelitian ini bertujuan untuk mengetahui peran HbA1c, GDS, neuropati, fibrinogen, PAI-1, hsCRP,indeks MMP-9, terhadap indeks TcPO2, indeks TcPCO2, dan indeks granulasi, serta mengetahuiperan serta indeks TcPO2 dan indeks TcPCO2 terhadap indeks granulasi pada luka kaki diabetik.Sebanyak 68 subjek LKD tanpa penyakit arteri perifer di RS dr. Cipto Mangukusumo dan beberaparumah sakit jejaring, pada Desember 2015?Desember 2016, diberikan perawatan standar dandipantau setiap minggu sebanyak 4 kali. Pada pemantauan ke-1, ke-2, dan ke-3, dilakukandokumentasi LKD, pengambilan darah vena sebanyak 7,7 mL untuk pemeriksaan fibrinogen, PAI-1,hsCRP, MMP-9, dan TIMP-1, darah arteri sebanyak 2 mL untuk pemeriksaan analisis gas darah,serta pemeriksaan TcPO2 dan TcPCO2 dengan menggunakan TCM TOSCA/CombiM monitoringsystems buatan Radiometer. Pada pemantauan ke-4, hanya dilakukan dokumentasi LKD.Pengukuran luas luka dan jaringan granulasi dinilai berdasarkan hasil dokumentasi fotografi denganmenggunakan program ImageJ. Penilaian neuropati menggunakan pemeriksaan interval RR dankecepatan hantar saraf. Data laboratorium lainnya diperoleh dari data sekunder rekam medis.Kemudian dilakukan analisis data dengan menggunakan path analysis (analisis lajur) pada datarepetitif dan SPSS pada data nonrepetitif.Berdasarkan analisis didapatkan hubungan antara peningkatan glukosa darah sewaktu, fibrinogen,dan PAI-1 dengan penurunan indeks TcPO2. Didapatkan juga hubungan antara beratnya neuropatimotorik dan sensorik, peningkatan glukosa darah sewaktu, fibrinogen, PAI-1, dan hsCRP denganpenurunan indeks granulasi. Tetapi, indeks granulasi tidak dipengaruhi oleh indeks TcPO2. IndeksTcPCO2 tidak memiliki hubungan terhadap semua variabel tersebut, kecuali hsCRP dan indeksTcPCO2 tidak memengaruhi indeks granulasi.Indeks TcPO2 pada LKD dipengaruhi oleh kadar glukosa darah sewaktu, fibrinogen, dan PAI-1,tetapi tidak memengaruhi tumbuhnya jaringan granulasi. Tumbuhnya jaringan granulasi dipengaruhioleh glukosa darah sewaktu, neuropati motorik dan sensorik, peningkatan kadar fibrinogen, PAI-1,dan hsCRP. Selain itu, indeks TcPCO2 tidak memengaruhi indeks granulasi

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ABSTRACT
Diabetic foot wounds/ulcer (DFU) is chronic complication of diabetes, which increasesmortality and morbidity, and lower quality of life. Macro and microvascular/microcirculationcomplications has a great influence on DFU and healing process. Microcirculation condition canbe seen from transcutaneous perfusion oxygen (TcPO2). The growth of granulation tissue in thehealing process is determined by microcirculation condition, among others influenced byHbA1c, random blood glucose, neuropathy, fibrinogen, PAI-1, hsCRP, MMP-9 index, TcPO2index, and TcPCO2 index.This study aimed to investigatethe role of HbA1c, random blood glucose, sensory, motoric, andautonomy neuropathy, fibrinogen, PAI-1, hsCRP, MMP-9 index, TcPO2 index, TcPCO2 index,and granulation index, as well as the relationship between TcPO2 index, TcPCO2 index andgranulation index in diabetic foot wounds.As much as 68 subjects DFU without peripheral arterial disease, in Cipto MangunkusumoReferral National Hospital, on December 2015?December 2016, were given standardmanagementof diabetic foot ulcer and monitored once a week for four times. In the 1st, 2nd, and3rd monitoring, DFU was documented, then 7.7 mL of venous blood was taken for fibrinogen,PAI-1, hsCRP, MMP-9, and TIMP-1 examination, also 2 mL arterial blood for blood gasanalysis, and then examination of TcPO2 and TcPCO2was performed using TCM4TOSCA/CombiM monitoring systems made by Radiometer. In the 4th monitoring, only DFUwas documented. Wound and granulation size was measured through photographicdocumentation using ImageJ program. Neuropathy was diagnosed based on RR interval andnerve conduction velocity study. Other laboratory data were obtained from medical records. Thedata were analysed by path analysis for repetititive data and SPSS for nonrepetitive data.From analysis, there is a significant correlation between the increasing random blood glucose(RBG), fibrinogen, and PAI-1 with the decreasing of TcPO2, also found a significantrelationship between the severity of sensory and motoric neuropathy, the increasing levels ofRBG, fibrinogen, PAI-1, and hsCRP with the decreasing of granulation index. But, TcPO2 indexdoes not influence granulation index. TcPCO2 index does not have significant correlation withall these variables, except hsCRP. Moreover, TcPCO2 index also does not influence granulationindex.TcPO2 index of DFU is affected by RBG, fibrinogen, PAI-1, but does not affect the growth ofgranulation tissue. Granulation tissue?s growing is influenced by the sensory and motoricneuropathy, increased levels of fibrinogen, PAI-1, and hsCRP. Furthermore, TcPCO2 index doesnot influence granulation?s growth.