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"Ekspresi transforming growth factor beta 1 (TGF β1) pada luka DM mengalami penurunan yang berdampak terhadap kenyamanan dan proses penyembuhan luka. Penelitian ini bertujuan menganalisa perbandingan perawatan luka teknik modern dan konvensional terhadap ekspresi TGF β1 dan respon nyeri pada luka DM. Penelitian menggunakan quasi experimental pretest-posttest design dengan metode pengumpulan sampel secara consecutive sampling. Pengukuran ekspresi TGF β1 dan respon nyeri dilakukan pada hari ke 0 (pretest) dan 4 (posttest). Sampel yang diambil yaitu pasien dengan luka kaki DM di Rumah Sakit Wilayah Malang dan Madiun. Ekspresi TGF β1 diukur dengan metode imunohistokimia di laboratorium Faal Divisi Fisiologi Molekuler dan Histologi FK Universitas Brawijaya Malang, sedangkan pengukuran respon nyeri dengan skala nyeri numerik yang telah teruji validitas dan reliabilitasnya. Hasil penelitian didapatkan data pada kelompok modern terjadi peningkatan ekspresi TGF β1 dan penurunan respon nyeri, sedangkan pada kelompok konvensional terjadi penurunan ekspresi TGF β1 dan peningkatan respon nyeri. Hasil uji t menunjukkan ada perbedaan perawatan luka teknik modern dan konvensional terhadap ekspresi TGF β1 dan respon nyeri pada luka DM (p value <0,05). Hasil uji korelasi pearson menunjukkan adanya hubungan yang signifikan antara perubahan respon nyeri dengan perubahan ekspresi TGF ß1 (p= 0,0005). Dapat disimpulkan bahwa teknik perawatan luka secara modern mampu meningkatkan ekspresi TGF β1 dan menurunkan respon nyeri dibandingkan teknik konvensional yang akan berpengaruh terhadap kenyamanan pasien secara fisik.

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Reduction of expression of transforming growth factor beta 1 (TGF β1) in diabetic ulcers affects overall wound healing and patient?s comfort. This study tried to draw a comparison of Transforming Growth Factor Beta 1 (TGF β1) level and pain response between modern dressing and conventional dressing in diabetic ulcer. This study applied a quasi-experimental pretest-posttest design and a consecutive sampling method of data collection. The data were collected from patients with diabetic foot ulcer at general hospitals in Malang and Madiun. Immunohistochemical analysis of TGF β1 level was measured on the day 0 (pretest) and the day 4 (posttest) in Physiology and Histology Laboratories, University of Brawijaya Medical Faculty. Pain response was also measured on the day 0 and day 4 using a validated and reliable numerical rating scale. In this study, the modern dressing application improves TGF β1 level and reduces pain response. Meanwhile, the conventional dressing application decreases TGF β1 level and intensifies pain response. T-test analysis showed significant differences between modern and conventional dressings in both TGF β1 level and pain response (p value < 0.05). Pearson?s correlation analysis showed a significant relation between pain response and TGF β1 level (p value = 0.0005). Thus, it can be concluded that the modern dressing application can increase TGF β1 level and decrease pain response. The combined effect of those may eventually promote physical comfort."

"Disertasi ini membahas algoritme neuromuscular taping terhadap manifestasi klinis gangguan mikrosirkulasi pada kaki dabetik. Tahapan riset meliputi kajian literatur, faktor risiko neuropati kaki diabetik, uji diagnostik, standarisasi perawatan pencegahan neuropati kaki diabetik, standarisasi NMT FANI pada perawatan neuropati kaki diabetik dan pembentukan algoritme. Desain penelitian uji diagnostik dengan cross sectional, sedangkan uji efek NMT FANI terhadap kelembapan, suhu, kapiler lipatan kuku dan nyeri neuropati dengan desain eksperimental. Instrument menggunakan moisture meter skin, thermometer infrared, capiloroscopy, biothesiometer dan LANSS. Hasil uji diagnostik menunjukan moisture meter skin (sensitifitas, spesifisitas dan akurasi 74%); capilaroscopy (sensitifitas, spesifisitas dan akurasi 73%) baik dalam mendeteksi neuropati kaki diabetik. Uji thermograph menunjukan sensitifitas 73.07% dalam mendeteksi kelainan neuropati, spesifisitas 56.42% dan akurasi 59.03%. Uji thermometer gun menunjukan sensitifitas 56.66%, spesifisitas 53.67% dan akurasi 54.21% kurang baik dalam mendeteksi neuropati kaki diabetik. NMT FANI berpengaruh secara signifikan terhadap kelembapan kulit, kapiler lipatan kulit kuku dan derajat nyeri neuropati pada kaki diabetik (p value < 0.05), sedangkan pada suhu kaki tidak berpengaruh secara signifikan (p value > 0.05). Hasil akhir algoritme tersusun dari pengkajian awal dari hasil anamnesis faktor risiko, pemeriksaan fisik dan diagnostik serta tatalaksana NMT FANI. Indikator kelembapan kulit, perubahan struktur kapiler lipatan kuku kaki dan intervensi NMT FANI perlu dimasukan dalam tatalaksana kaki diabetik.

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This dissertation discusses the neuromuscular taping algorithm against the clinical manifestations of microcirculation disorders in the diabetic foot. The research stages included a review of literature, risk factors for neuropathy of diabetic foot, diagnostic tests, standardization of preventive treatment of diabetic foot neuropathy, standardization of NMT FANI in the treatment of diabetic foot neuropathy, and algorithm formation. The study design was a cross-sectional diagnostic test, while an experimental design was employed for the NMT FANI effect test on skin moisture, temperature, nail fold capillaries, and neuropathic pain. The instruments used were a skin moisture meter, infrared thermometer, capillaroscopy, biothesiometer, and LANSS. The diagnostic test results showed that the SC skin moisture meter (sensitivity, specificity, accuracy 74%) and capillaroscopy (sensitivity, specificity, accuracy 73%) were good at detecting diabetic foot neuropathy. The thermograph test shows a sensitivity of 73.07% in detecting neuropathic disorders, a specificity of 56.42% and an accuracy of 59.03%. The thermometer gun test showed a sensitivity of 56.66%, a specificity of 53.67%, and an accuracy of 54.21% that was not good at detecting diabetic foot neuropathy. NMT FANI had a significant effect on skin moisture, nail fold capillaries, and the degree of neuropathy pain in diabetic foot (p value < 0.05), while foot temperature did not significantly influence (p value > 0.05). The end result of the algorithm is composed of a preliminary assessment of the results of the history of risk factors, physical examination, diagnostic and management of NMT FANI. Indicators of skin moisture, changes in the capillary structure of the nail folds and NMT FANI interventions need to be included in the management of diabetic foot."