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"Diabetik melitus mengakibatkan komplikasi, salah satunya adalah ulkus. Penelitian kuasi eksperimen dengan pendekatan nonequivalent control group design ini bertujuan mendapatkan gambaran "pengaruh elevasi ekstremitas bawah terhadap proses penyembuhan ulkus diabetik di ilayah Banten". Sampel penelitian adalah pasien diabetes melitus dengan ulkus berjumlah 7 orang kelompok ontrol dan 6 orang kelompok intervensi.Hasil penelitian menunjukkan ada pengaruh elevasi ekstremitas bawah terhadap proses penyebuhan ulkus (p value 0,003). Perawat seharusnya melakukan elevasi pada ekstremitas bawah yang mengalami ulkus diabetik selama 10 menit setiap aktivitas >15 menit.

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Diabetes mellitus result complication, one of the is ulcer. This quasi experiment research with group control nonequivalent design approach aim to get a description about"influence of elevation of lower extremity to diabetic ulcer healing proces in Banten". Sample in this research were diabetes mellitus patient with ulcer, consist of 7 repondent in control group and 6 repondent in intervention group.The result showed that lower extremity elevation were significantly associated with diabetic ulcer healing processs (p value 0,003). Nurse should be elevate the lower extremity with diabetic ulcer during 10 minutes after activity more than 15 minutes."

"Ulkus kaki diabetik adalah komplikasi kronik diabetes melitus yang mengakibatkan kerusakan kulit yang dapat meluas ke tendon, otot, tulang atau persendian. Ulkus kaki, infeksi, neuroarthropati dan penyakit arteri perifer mengakibatkan gangren dan amputasi ekstremitas bagian bawah. Tujuan penelitian ini untuk mengetahui pengaruh latihan ROM ankle terhadap proses penyembuhan ulkus kaki diabetik di rumah sakit di propinsi Lampung. Penelitian ini menggunakan desain kuasi eksperimen pre post test dengan kelompok kontrol, melibatkan 7 responden kelompok intervensi dan 7 responden kelompok kontrol. Teknik pengambilan sampel dengan non probability consecutive sampling.Penelitian ini menggunakan t test, diperoleh hasil adanya perbedaan yang signifikan rata-rata skor penyembuhan ulkus kaki diabetik antara kelompok intervensi dan kelompok kontrol setelah dilakukan latihan ROM ankle (p= 0,001; α = 0,05 ). Demikian juga terbukti tidak ada hubungan antara lama sakit DM (p = 0,656 ; α = 0,05), GDN (p = 0,648 ; α = 0,05), GDPP (p = 0,883 ; α = 0,05) dan infeksi ulkus (p = 1,000; α = 0,05) dengan skor penyembuhan ulkus kaki diabetik.Peneliti memberikan saran agar latihan ROM ankle dapat diterapkan pada perawatan ulkus kaki diabetik sesuai dengan formula yang ada. Penelitian lebih lanjut perlu dilakukan dengan jenis gerakan yang lain, melibatkan tidak hanya sendi ankle. Selain itu dilakukan penelitian dengan jumlah sampel yang lebih besar.

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Diabetic foot ulcer is a chronic complication of diabetes melitus disease resulting in destructruction of skin that can spread to tendons, muscles, bones or joints. Foot ulcers, infections, neuroarthropati and peripheral arterial disease lead to gangrene and amputation of the lower extremities. The purpose of this study was to determine the effect of ankle ROM exercises on the healing of diabetic foot ulcers in the hospital province of Lampung. This study used quasi-experimental design pre-post test with control group. This study recruited 7 respondents intervention group and 7 respondents control group by non probability consecutive sampling.

The t test result showed that there was a significant difference in the mean score of the healing of diabetic foot ulcers between the intervention and control group after ankle ROM exercise (p = 0.001; α = 0.05). There are no relationship among the illness period of DM (p = 0.656; α = 0.05), GDN (p = 0,648 ; α = 0,05), GDPP (p = 0,883 ; α = 0,05) and ulcers infection (p = 1.000; α = 0,05) with a score of healing diabetic foot ulcers.

The researcher suggested that ankle ROM exercises could be applied to the diabetic foot ulcers care in accordance with the existing formula. Further research needs to be done with other types of movement, involving not only the ankle joint, but also other parts of joints. In addition the study should be recruite a larger number of samples."

"Latar belakang: Ulkus kaki diabetik adalah komplikasi umum yang terjadi pada penderita diabetes mellitus (DM). Penurunan aliran darah berkontribusi terhadap kronisitas ulkus kaki diabetik. Vibrasi diduga berdampak pada perbaikan aliran darah. Tujuan dari penelitian ini adalah untuk mengetahui efektifitas vibrasi terhadap percepatan penyembuhan ulkus kaki diabetik. Metode: Penelitian ini merupakan penelitian eksperimen dengan desain penelitian yang digunakan adalah randomized clinical trial (RCT) non blinding. Subyek penelitian merupakan pasien dengan ulkus kaki diabetik derajat 0-2 yang dibagi menjadi 2 kelompok yaitu kelompok kontrol dan kelompok intervensi. Pada kelompok intervensi, vibrasi diberikan dengan dosis 3 kali sehari dengan lama pemberian 15 menit sampai luka dinyatakan sembuh. Hasil: Penelitian ini menunjukkan perbedaan bermakna (p<0,05) pada laju kesembuhan, rerata skor penyembuhan luka khususnya pengamatan minggu pertama dan kedua serta rerata penutupan area luka. Laju kesembuhan dan penutupan luka pada kelompok intervensi lebih cepat dibandingkan kontrol. Vibrasi juga meningkatkan kadar nitric oxide (NO) setelah intervensi diberikan dan menunjukkan perbedaan bermakna antara kedua kelompok. Sebagai luaran sekunder didapatkan hubungan antara kadar NO dengan laju kesembuhan dan penutupan area luka. Kesimpulan: Pemberian vibrasi efektif mempercepat penyembuhan ulkus kaki diabetik diukur dari laju kesembuhan, skor penyembuhan, penutupan area luka dan kadar NO.

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Background: Diabetic foot ulcer is a common complication in patient with diabetes mellitus. The decreased blood flow has a role in the chronicity of diabetic foot ulcer. Vibration therapy was supposed to be able to improve the blood flow. The aim of this study was to evaluate the effect of vibration on the acceleration of healing of diabetic foot ulcer.

Method: This experimental study used a randomized clinical trial non blinding design. Patients with diabetic foot ulcers grade 0-2 were divided into control group and intervention group. Patients in intervention group received vibration as an adjuvant to standard therapy, three times a day, each for 15 minutes, until the wound were healed.

Results: There were significant differences (p<0.05) in terms of healing rate, wound healing score (especially at the end of week 1 and week 2), and the wound closure area. The rate of wound healing and wound closure were significantly higher in the intervention group. The level of nitric oxide (NO) was also significantly higher in the intervention group. As an additional outcome, there was a positive association between the level of NO and the rate of healing and wound closure.

Conclusion: Vibration therapy accelerated the healing of diabetic foot ulcer in terms of healing rate, healing score, wound closure area, and elevated the level of NO."

"Luka kaki diabetes (LKD) merupakan komplikasi penyakit diabetes yang disebabkan oleh gangguan sirkulasi darah vena dan arteri. Buerger allen exercise adalah terapi modalitas dengan gerakan postural aktif. Penelitian ini bertujuan untuk menilai pengaruh buerger allen exercise tehadap peningkatan sirkulasi ektremitas bawah pasien LKD. Desain penelitian adalah pre eksperimen pretest dan posttest without control. Teknik pengambilan sampel adalah consecutive sampling sebanyak sampel 43 responden LKD, analisis data menggunakan uji Wilcoxon. Peningkatan sirkulasi di ukur menggunakan Ankle Brachial Index (ABI). Latihan dilakukan sebanyak 2 kali sehari dengan waktu latihan 17 sampai 20 menit, selama 3 minggu. Hasil penelitian menunjukkan perbedaan signifikan antara nilai rata-rata ABI sebelum 0,84 dan sesudah 0,95 intervensi Buerger allen exercise dengan nilai p= 0,000. Buerger allen exercise efektif untuk meningkatkan sirkulasi LKD karena perubahan posisi dan gaya gravitasi membantu mengosongkan dan mengisi kolom darah, sedangkan kontraksi muskulus gastrocnemius sebagai muscle pump mengaktivasi pembuluh darah vena dan arteri untuk membuka jalur sirkulasi collateral lokal.

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Diabetic foot ulcer (DFU) is a complication of diabetes caused by impaired venous and arterial blood circulation. Buerger allen exercise is a modality therapy with active postural movement. This study aims to assess the effect of buerger allen exercise on the circulation of lower extremities in DFU patients. The study design was pre experimental pretest and posttest without control. The sampling technique was consecutive sampling and the large sample of 43 DFU patients, analysis data was using Wilcoxon test. Increased circulation is measured using the Ankle Brachial Index (ABI). Exercise done as much as 2 times a day with practice time 17 to 20 minutes, for 3 weeks. The results showed a significant difference between the average value of ABI before 0.84 and after 0.95 intervention of Buerger allen exercise with a value of p = 0.000. Buerger allen exercise is effective for improving DFU circulation because position changes and gravitational forces help to empty and fill the blood column, and the contraction of the gastrocnemius as a muscle pump activates the venous and arteries and opens the local collateral circulatory pathway."

"Latar Belakang: Penyakit ginjal kronik (PGK) dilaporkan berhubungan dengan peningkatan risiko kejadian ulkus pedis dan amputasi pada diabetes melitus (DM). Namun, data mengenai hal tersebut masih terbatas termasuk di Indonesia. Tujuan penelitian ini adalah untuk mengetahui pengaruh PGK terhadap kejadian ulkus pedis dan amputasi ekstremitas bawah dalam 3 tahun.Metode: Penelitian ini merupakan studi kohort retrospektif pada DM berusia >18 tahun dengan menggunakan data sekunder di RSUP Fatmawati pada periode Januari – Desember 2016. Kesintasan terhadap ulkus pedis dan amputasi ekstremitas bawah berdasarkan LFG dihitung dan dianalisis melalui kurva Kaplan Meier. Adjusted hazard ratio (aHR) dinilai dengan menggunakan analisis multivariate Cox proportional hazards. Hasil: Dari 204 subjek penelitian, 108 orang (52,9%) memiliki LFG > 60, 54 orang (26,5%) memiliki LFG 30-59, dan 42 orang (20,6%) memiliki LFG <30 ml/menit/1,73 m2. Kesintasan ulkus pedis dalam 3 tahun adalah 75,7% untuk LFG <30; 86,4% untuk LFG 30-59; dan 94,1% untuk LFG > 60 ml/menit/1,73 m2. Laju insidens ulkus pedis per 1000 orang per bulan adalah 7,98 untuk LFG <30; 4,08 untuk LFG 30-59; dan 1,61 untuk LFG >60 ml/menit/1,73m2. Pasien dengan LFG 30-59 dan LFG <30 ml/menit/1,73 m2 memiliki adjusted HR 1,36 (IK 95% 0,39-4,66) dan 4,39 (IK 95% 1,18-16,4) terhadap ulkus pedis dibandingkan dengan LFG > 60 ml/menit/1,73 m2. Tidak dilakukan analisis lebih lanjut pada luaran amputasi ekstremitas bawah karena tidak ada pasien yang mengalami luaran pada kelompok LFG >60 ml/menit/1,73 m2Kesimpulan: PGK mempengaruhi kejadian ulkus pedis dalam 3 tahun pada pasien DM dan risiko ulkus pedis dalam 3 tahun semakin meningkat seiring dengan semakin berat derajat PGK. Pengaruh PGK terhadap kejadian amputasi ekstremitas bawah masih belum dapat disimpulkan pada penelitian ini.

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Background: Chronic kidney disease (CKD) has been reported associated with poor prognoses in foot ulcers and lower extremity amputation (LEA) in patients with diabetes melitus (DM). However, the study is still limited and never been done in Indonesia. The objective of this study is to evaluate the impact of CKD on foot ulcers and LEA in patients with diabetes.

Methods: This was a retrospective cohort study in Internal Medicine out-patient clinic in Fatmawati General Hospital. All subjects were enrolled between January-December 2016 who had history of DM, age >18 years old and had a history of DM. Foot ulcer-free and amputation-free survival for estimated glomerular filtration rate (eGFR) >60, 30-59, and <30 ml/min/1,73 m2 were calculated and analyzed by Kaplan-Meier curves. Adjusted hazard ratio (HR) was analalyzed using multivariate Cox proportional hazards. multivariate model.

Results: A total of 204 individuals were included: 108 (52,9%) in eGFR >60, 54 in eGFR 30-59, and 42 in eGFR <30 ml/min/1,73 m2. Foot ulcer free survival for patient with eGFR <30, 30-59, >60 ml/min/1.73 m2 were 75,7%; 86,4%; and 94,1% respectively. Unadjusted foot ulcer incidence rates per 1000 patients per month were 7,98 for eGFR <30; 4,08 for eGFR 30-59; and 1,61 for eGFR >60 ml/menit/1.73m2. For the development of foot ulcer compared with eGFR > 60 ml/min/ 1.73 m2, adjusted HR for patient with eGFR 30-59 ml/min/1.73 m2 was 1,36 (CI 95% 0,39-4,66) and for eGFR < 30 ml/min/1.73 m2 was 4,39 (CI 95% 1,18-16,4). HR for LEA could not be analyzed because there were no patient who had been amputated after 3 years follow up in group eGFR >60 ml/min/1.73 m2.

Conclusion: CKD increased the risk of foot ulcer in 3 years among DM patients. The risk was increased concomitant with the severity of CKD. The impact of CKD on LEA could not be concluded in this study."

"ABSTRAK Ulkus kaki diabetik mengakibatkan mortalitas yang semakin meningkat terutamapasca amputasi, beban yang signifikan pada pembiayaan kesehatan danmenyebabkan hilangnya produktivitas. Penelitian ini bertujuan untuk mengetahuiefektivitas terapi kombinasi dari laserpunktur dan perawatan luka konvensionaldibandingkan dengan laserpunktur sham dan perawatan luka konvensionalterhadap penyembuhan ulkus kaki diabetik. Uji klinis acak tersamar ganda denganpembanding dilakukan terhadap 36 pasien yang dialokasikan ke dalam kelompokkasus atau kelompok kontrol. Tindakan laserpunktur dilakukan pada titik LI4Hegu, ST36 Zusanli, SP6 Sanyinjiao, dan KI3 Taixi bilateral serta penyinaranpada ulkus dua kali seminggu, selama empat minggu. Rerata ukuran ulkus kakidiabetik sebagai keluaran primer diukur setiap minggu. Hasil penelitianmenunjukkan perbedaan yang bermakna antara penurunan luas luka akhir dikelompok laserpunktur dan perawatan luka konvensional dengan kelompoklaserpunktur sham dan perawatan luka konvensional (p=0,006). Dapatdisimpulkan bahwa terapi kombinasi laserpunktur dan perawatan lukakonvensional efektif mempercepat penyembuhan ulkus kaki diabetik denganfrekuensi terapi dua kali seminggu. ABSTRACT Diabetic foot ulcers result in mortality is increasing, especially after theamputation, a significant burden on health financing and lead to loss ofproductivity. This study aims to determine the effectiveness of the combinationtherapy between laserpuncture and conventional wound care compared withsham laserpuncture and conventional wound treatment for healing diabetic footulcers. Double-blind randomized clinical trial with a control carried out on 36patients allocated to the case group or control group. Laserpuncture actionsperformed on LI4 point Hegu, Zusanli ST36, SP6 Sanyinjiao and Taixi KI3bilateral as well as exposure to ulcers twice a week, for four weeks. The mean sizeof diabetic foot ulcers as the primary output is measured every week. The resultsshowed a significant difference between the reduction in wound area at the end ofthe group laserpuncture and conventional wound care compare withlaserpuncture sham group and conventional wound treatment (p = 0.006). It canbe concluded that the combination therapy laserpuncture and conventional woundcare effectively accelerate the healing of diabetic foot ulcers with frequencytherapy twice a week.;Diabetic foot ulcers result in mortality is increasing, especially after theamputation, a significant burden on health financing and lead to loss ofproductivity. This study aims to determine the effectiveness of the combinationtherapy between laserpuncture and conventional wound care compared withsham laserpuncture and conventional wound treatment for healing diabetic footulcers. Double-blind randomized clinical trial with a control carried out on 36patients allocated to the case group or control group. Laserpuncture actionsperformed on LI4 point Hegu, Zusanli ST36, SP6 Sanyinjiao and Taixi KI3bilateral as well as exposure to ulcers twice a week, for four weeks. The mean sizeof diabetic foot ulcers as the primary output is measured every week. The resultsshowed a significant difference between the reduction in wound area at the end ofthe group laserpuncture and conventional wound care compare withlaserpuncture sham group and conventional wound treatment (p = 0.006). It canbe concluded that the combination therapy laserpuncture and conventional woundcare effectively accelerate the healing of diabetic foot ulcers with frequencytherapy twice a week.;Diabetic foot ulcers result in mortality is increasing, especially after theamputation, a significant burden on health financing and lead to loss ofproductivity. This study aims to determine the effectiveness of the combinationtherapy between laserpuncture and conventional wound care compared withsham laserpuncture and conventional wound treatment for healing diabetic footulcers. Double-blind randomized clinical trial with a control carried out on 36patients allocated to the case group or control group. Laserpuncture actionsperformed on LI4 point Hegu, Zusanli ST36, SP6 Sanyinjiao and Taixi KI3bilateral as well as exposure to ulcers twice a week, for four weeks. The mean sizeof diabetic foot ulcers as the primary output is measured every week. The resultsshowed a significant difference between the reduction in wound area at the end ofthe group laserpuncture and conventional wound care compare withlaserpuncture sham group and conventional wound treatment (p = 0.006). It canbe concluded that the combination therapy laserpuncture and conventional woundcare effectively accelerate the healing of diabetic foot ulcers with frequencytherapy twice a week."

"Gangguan sirkulasi kaki pada penderita DM mengakibatkan proses penyembuhan ulkus diabetik tertunda. Tujuan dari penelitian ini yaitu mengidentifikasi pengaruh Ankle Range of Motion (ROM) Exercise terhadap penyembuhan luka pada pasien ulkus diabetik. Sampel dalam penelitian ini berjumlah 28 responden yang dibagi menjadi 14 responden kelompok intervensi dan 14 responden kelompok kontrol. Metode penelitan ini adalah quasi eksperimental design dengan pendekatan Pretest and Posttest With Control Group Design. Kelompok intervensi diberikan perlakuan ankle Range of Motion (ROM) exercise dan perawatan luka modern dressing, sedangkan kelompok kontrol hanya diberikan perawatan luka modern dressing saja. Ankle Range of Motion (ROM) exercise terdiri dari empat gerakan yaitu plantarfleksi, dorsofleksi, inversi dan eversi. Latihan ini termasuk dalam latihan tidak menahan beban dan aman dilakukan pada penderita ulkus diabetik. Hasil penelitian menunjukan bahwa ada perbedaan yang signifikan rerata selisih skor penyembuhan luka antara kelompok intervensi dengan kontrol dengan p value 0,000 (< 0,05). Hasil uji variabel confounding menunjukkan bahwa tidak ada hubungan antara riwayat merokok terhadap skor penyembuhan luka pada pasien ulkus diabetik dengan p value 0,143 (> 0,05). Ankle Range of Motion (ROM) Exercise diharapkan dapat dijadikan terapi tambahan dalam manajemen luka pada pasien ulkus diabetik untuk mempercepat proses penyembuhan luka

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Impaired foot circulation in diabetic patients causes the healing process of diabetic ulcers to be delayed. The purpose of this study was to identify the effect of Ankle Range of Motion (ROM) Exercise on wound healing in diabetic ulcer patients. The sample in this study amounted to 28 respondents who were divided into 14 respondents in the intervention group and 14 respondents in the control group. This research method is a quasi-experimental design with a Pretest and Posttest approach with Control Group Design. The intervention group was treated with ankle Range of Motion (ROM) exercise and modern wound dressings, while the control group was only given modern wound dressings. Ankle Range of Motion (ROM) exercise consists of four movements, namely plantarflexion, dorsiflexion, inversion and eversion. This exercise is included in non-weight-bearing exercises and is safe for diabetic ulcer sufferers. The results showed that there was a significant difference in the mean difference in wound healing scores between the intervention group and the control group with a p value of 0.000 (<0.05). The results of the confounding variable test showed that there was no relationship between smoking history and wound healing scores in diabetic ulcer patients with a p value of 0.143 (> 0.05). Ankle Range of Motion (ROM) Exercise is expected to be used as additional therapy in wound management in diabetic ulcer patients to accelerate the wound healing process."

"Diabetes sering menyebabkan komplikasi ulkus kaki diabetik (UKD) yang penyembuhannya terhambat pada fase inflamasi dan terjadi gangguan pada pembentukan jaringan granulasi. LL-37 memiliki aktivitas antimikrobial, memicu angiogenesis, serta migrasi dan proliferasi keratinosit. Penelitian ini menganalisis pengaruh krim LL-37 terhadap kecepatan penyembuhan UKD derajat ringan dengan mengkaji IL-1a, TNF-a, serta pola dan jumlah kolonisasi bakteri aerob.Penelitian ini adalah uji klinis buta ganda acak yang dilaksanakan Januari 2020–Juni 2021 di RSUPN dr. Cipto Mangunkusumo dan RSUP Persahabatan, Jakarta. Subjek adalah penyandang UKD tanpa infeksi atau infeksi derajat ringan, berusia 18–60 tahun, ABI 0,9–1,3, luas luka ≥ 2 cm2, kedalaman luka sampai dengan subkutis, dan tanpa infeksi sistemik. Subjek dibagi menjadi kelompok krim LL-37 dan plasebo yang dioles dua kali seminggu selama 4 minggu. Dilakukan pengamatan luka pada akhir minggu dengan metode planimetri dan fotografi digital lalu diolah dengan ImageJ. Subjek diperiksa kadar IL-1a dan TNF-a cairan luka dengan metode ELISA dan kultur bakteri aerob dari apusan luka pada setiap akhir minggu.Kadar LL-37 cairan luka pada kelompok LL-37 adalah 1,07 (0,37–4,96) ng/mg protein dan plasebo sebesar 1,11 (0,24–2,09) ng/mg protein (p = 0,44). Penurunan luas luka pada hari ke-14, ke-21, dan ke-28 dibandingkan hari ke-1 pada kelompok LL-37 lebih besar daripada plasebo, walaupun tidak bermakna. Pada kelompok LL-37 terjadi peningkatan luas jaringan granulasi yang lebih besar daripada plasebo pada semua hari, walaupun hanya bermakna pada hari ke-14 yaitu 0,95 (±1,34) cm2 pada kelompok LL-37 dibandingkan -0,24 (±1,01) cm2 pada kelompok plasebo (p = 0,020). Terjadi peningkatan indeks granulasi yang secara konsisten lebih besar dan bermakna (p < 0,05) pada kelompok LL-37 dibandingkan plasebo pada semua hari. Tidak terjadi penurunan kadar IL-1a dan TNF-a yang lebih besar pada kelompok LL-37. Pada hari ke-1, frekuensi bakteri aerob terbanyak adalah S. aureus yaitu 37,1% pada kelompok LL-37 dan 45% pada kelompok plasebo. Penurunan jumlah koloni bakteri pada kelompok plasebo lebih besar dibandingkan dengan kelompok LL-37 pada hari ke-28 dibandingkan dengan hari ke-1, walaupun tidak bermakna (p = 0,98).Simpulan: Kadar LL-37 pada UKD kedua kelompok rendah. Pemberian LL-37 mempercepat penyembuhan UKD tanpa infeksi maupun derajat ringan dengan meningkatkan indeks granulasi. Pemberian LL-37 tidak menurunkan kadar IL-1a dan TNF-a pada UKD. Pemberian LL-37 tidak memengaruhi pola dan jumlah kolonisasi bakteri aerob pada UKD.

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Diabetes often causes DFU (diabetic foot ulcer). Wound healing in DFU has prolonged inflammation phase and defective granulation tissue formation. LL-37 has antimicrobial property, induces angiogenesis, and keratinocyte migration and proliferation. This study analyzes the efficacy of LL-37 cream on wound healing rate in DFU with mild infection by examining IL-1a, TNF-a, and aerobic bacteria colonization.

This study was a randomized double-blind controlled trial conducted from January 2020–June 2021 at RSUPN dr. Cipto Mangunkusumo and RSUP Persahabatan, Jakarta. Subjects were patients with uninfected DFU or DFU with mild infection according to IDSA, aged 18–60 years old, ABI 0.9–1.3, wound area ≥ 2 cm2, wound no deeper than subcutaneous layer, and without systemic infection. Subjects were divided into the LL-37 cream and placebo cream group which were applied twice a week for 4 weeks. Wounds were measured at the end of every week using planimetric method and digital photography and subsequently processed with ImageJ. The levels of IL-1a and TNF-a from wound fluid were measured using the ELISA method and aerobic bacteria culture was performed using wound swabs.

The level of LL-37 from wound fluid in the LL-37 group was 1.07 (0.37–4.96) ng/mg protein and in the placebo group was 1.11 (0.24–2.09) ng/mg protein (p = 0.44). The decrease in wound area on day 14, 21, and 28 compared to day 1 in the LL-37 group was greater than in the placebo group, although the difference was not significant. In the LL-37 group, there was a greater increase in granulation tissue area than in the placebo group on each day, although the difference was only significant on day 14 which was 0.95 (±1.34) cm2 in the LL-37 group compared to -0.24 (± 1.01) cm2 in the placebo group (p = 0.020). There was a consistently and significantly greater increase in granulation index (p < 0.05) in the LL-37 group compared to placebo group on each day. There was no greater decrease in IL-1a and TNF-a levels in the LL-37 group. On day 1, the highest frequency of aerobic bacteria was S. aureus which was 37.1% in the LL-37 group and 45% in the placebo group. The decrease in the number of bacterial colonies in the placebo group was greater than in the LL-37 group on day 28 compared to day 1, although the difference was not significant (p = 0.98).

Conclusion: The level of LL-37 in DFU was low in both groups. Administration of LL-37 accelerated the healing of uninfected DFU or DFU with mild infection by increasing the granulation index. Administration of LL-37 did not reduce the levels of IL-1a and TNF-a in DFU. Administration of LL-37 did not affect the pattern and number of colonization of aerobic bacteria in DFU."

"Depresi pasien ulkus diabetikum dapat menurunkan respon imun dan inflamasi yang dibutuhkan pada proses penyembuhan luja. Penelitian kuasi eksperimen ini bertujuan untuk mengidentifikasi pengaruh pengelolaan depresi dengan pranayama terhadap perkembangan proses penyembuhan ulkus diabetikum di RS pemerintah Aceh. Hasil penelitian menunjukkan latihan pranayama dapat mempengaruhi perkembangan proses penyembuhan ulkus dan penurunan skor depresi, namun tidak ditemukan pengaruh pengelolaan depresi dengan pranayama terhadap perkembangan proses penyembuhan ulkus diabetikum.

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Depression on patient with diabetic ulcer impair immune and inflammation response that are needed in wound healing process. The urpose of this quasi experiment research was to identified the effect of pranayama on patient diabetic ulcer in Aceh government hospital. The result showed that pranayama has positive effect to wound healing progress and to decrease the depression score. But there was no effect of controlling depression by pranayama to wound healing progress."

"Pembedahan Open Reduction and Internal Fixation menimbulkan pembengkakan jaringan dan nyeri hebat pada area pembedahan. Salah satu upaya nonfarmakologis mengurangi pembengkakan dan nyeri adalah melakukan elevasi bagian distal yang dilakukan pembedahan. Tujuan penelitian untuk mengetahui pengaruh elevasi 20 derajat terhadap pembengkakan dan tingkat nyeri pada pasien pascabedah Open Reduction and Internal Fixation ekstremitas bawah. Penelitian dilakukan dengan desain quasi eksperimental rancangan two group pretest-posttest with control group dengan subyek penelitian sebanyak 34 responden yang dibagi menjadi kelompok intervensi dan kelompok kontrol. Pengukuran circumference pembengkakan menggunakan pita meter dan tingkat nyeri dengan skala Numeric Rating Scale. Penggunaan uji statistik dengan uji T dependen, uji T independent dan korelasi Pearson. Hasil penelitian terdapat perbedaan yang signifikan selisih rerata penurunan circumference pembengkakan sebesar 1,93 cm dan tingkat nyeri sebesar 1,29 antara kelompok intervensi dan kelompok kontrol. Elevasi 20 derajat ekstremitas bawah dapat menjadi alternatif tindakan keperawatan mandiri dalam menurunkan pembengkakan dan nyeri.

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Surgery for Open Reduction and Internal Fixation causes tissue swelling and severe pain in the surgical area. One nonpharmacological effort to reduce swelling and pain is to perform distal elevation in the area of surgical. The purpose of this study was to determine the effect of a 20 degrees elevation on swelling and the level of pain in patients after surgery for Open Reduction and Internal Fixation of the lower extremities. The study with a quasi-experimental design of two group pre-test and post-test with control group with 34 subjects was divided into intervention and control groups. Swelling circumference measurements using tape meters and the level of pain with the scale of the Numeric Rating Scale. This study used dependent T test, independent T test and Pearson correlation. The results of the study showed that there were significant differences in the mean difference in the swelling circumference of 1.93 cm and the pain level of 1.29 between the intervention group and the control group. Elevation of 20 degrees of lower extremity can be an alternative for nursing intervention in reducing swelling and pain."