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Abstrak :
Latar belakang: Ulkus Kaki diabetik atau Diabetic Foot Ulcer merupakan salah satu komplikasi yang berat, karena sering kali ulkus kaki diabetik berakhir dengan amputasi kecacatan dan kematian. USG Doppler merupakan modalitas yang mudah tersedia dan non invasif untuk evaluasi arteri ekstremitas inferior dan dapat mendeteksi tingkat keparahan gangguan aliran darah atau Penyakit Arteri Perifer (PAP) dengan sensitivitas 42,8% dan spesifisitas 97,5%. WHO merekomendasikan klasifikasi Perfusion, Extent/Size, Depth/Tissue Loss, Infection, Sensation (PEDIS) sebagai sarana penegakan diagnosis dan membantu menentukan tatalaksana kaki diabetik. Penelitian ini dilakukan untuk melihat korelasi skor PEDIS dalam menilai gangguan aliran arteri tungkai berdasarkan spektral USG Doppler pada penderita ulkus kaki diabetik di RS Cipto Mangunkusumo Jakarta. Subjek dan Metode: Subjek penelitian adalah pasien ulkus kaki diabetes yang dirawat di Divisi Bedah Vaskular dan Endovaskular FKUI-RS Cipto Mangunkusumo Jakarta dan memenuhi kriteria inklusi dan eksklusi. Penelitian ini dilakukan dengan perhitungan menggunakan sensitivitas estimasi sebesar 80%, error absolut (d=5%), prevalensi estimasi 51,8% maka besar sampel minimal adalah 76. Setelah itu diperoleh data berupa skor PEDIS dan hasil spektral USG pada arteri femoralis, arteri poplitea, arteri dorsalis pedis dan arteri tibialis posterior. Penelitian ini mengumpulkan 81 orang subjek dengan 52 orang (64%) jenis kelamin laki-laki, 29 orang (36%) perempuan dan rata-rata usia 59,8+10,5 tahun. Profil gula darah sewaktu subjek median 265 mg/dl dengan kisaran antara 105-571 mg/dl. Pada tabel 3 dalam menentukan Cut Off skor PEDIS menggunakan kurva ROC (Receiver Operating Characteristic), didapatkan Cut Off arteri poplitea >10, sedangkan arteri dorsalis pedis dan arteri tibialis posterior >8.

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Main topics: Diabetic Foot Ulcer or Diabetic Foot Ulcer is one form that is severe, because often diabetic foot ulcers end with disability amputation and death. Doppler ultrasound is an easily available and unlimited modality for lower limb risk and can detect the severity of arterial disease or peripheral arterial sensitivity (PAP) with a sensitivity of 42.8% and specificity of 97.5%. WHO that performs Data Perfusion, Area/Size, Depth/Tissue Loss, Infection, Sensation (PEDIS) as a means of enforcing the diagnosis and helps determine the management of diabetic foot. This study was conducted to look at the PEDIS score in assessing the disturbance of limb arterial flow based on Doppler ultrasound in patients with diabetic foot ulcer at Cipto Mangunkusumo Hospital, Jakarta. Subjects were patients with diabetic foot ulcers performed in the Division of Vascular and Endovascular Surgery of the Faculty of Medicine-Cipto Mangunkusumo Hospital Jakarta and fulfilled the inclusion and exclusion criteria. This research was conducted by calculating using an estimation sensitivity of 80%, absolute error (d = 5%), the largest prevalence of 51.8%, then the minimum sample size was 76. After that data was obtained in the form of PEDIS scores and spectral results of ultrasound in the femoral artery, arteries poplitea, dorsalis pedis artery and posterior tibial artery. This study collected 81 subjects with 52 people (64%) male gender, 29 people (36%) women and an average of 59.8 + 10.5 years. The blood sugar profile was median 265 mg/dl with a range of 105-571 mg/dl. In table 3 in determining the PEDIS score Cut-Off using the Receiver Operating Characteristic curve, obtained Cut-ff popliteal artery> 10, while the dorsalis pedis artery and posterior tibial artery> 8.

Abstrak :
Introduction: Diabetic foot ulcer is one of the most severe complications in a patient with diabetes mellitus because it will lead to with amputation, which results in disability and death. Doppler ultrasound is an easily available and non-invasive modality for evaluating lower limb arteries and can detect the severity of blood flow disorders or peripheral arterial disease (PAD). WHO recommends the classification of perfusion, extent/size, depth/tissue loss, infection, and sensation (PEDIS) as a tool for establishing the diagnosis and helping determine the management of diabetic foot. This study aims to see the correlation of PEDIS scores in assessing impaired lower limb arterial flow with Doppler ultrasound in patients with diabetic foot ulcers. Method: This was a cross-sectional study with subjects who has diabetic foot ulcer treated in the Division of Vascular and Endovascular Surgery, Cipto Mangunkusumo Hospital, Jakarta, Indonesia. The data of PEDIS scores and spectral ultrasound in the femoral artery, popliteal artery, dorsalis pedis artery, and posterior tibial artery were taken. Results: As many as 81 subjects participated in this study, with 52 people (64%) were male, 29 people (36%) were female, and an average age of 59.8 ± 10.5 years. Pedis cut-off scores were obtained using ROC (receiver operating characteristic) curves, with popliteal arteries scores of >10, dorsalis pedis arteries, and posterior tibial arteries scores of >8 had the best values as diagnostic tools compared to USG as reference standards.

Abstrak :
Ulkus kaki diabetik (UKD) merupakan luka kronik pada pasien diabetes melitus (DM). Vitamin D dipercaya memiliki peran penting pada diferensiasi, proliferasi, pertumbuhan sel, dan modulasi sistem imunitas sehingga kadar yang optimal dibutuhkan untuk penyembuhan luka. Defisiensi vitamin D juga diduga mengganggu produksi dan sekresi insulin sehingga berkontribusi pada kronisitas UKD. Penelitian bertujuan membandingkan kadar vitamin D pada pasien DM dengan dan tanpa UKD; serta untuk mengetahui korelasi antara durasi UKD dan keparahan UKD berdasarkan skor PEDIS (perfusion, extension, depth, infection, sensation) dengan kadar vitamin D. Serum 25-hidroksivitamin D (25(OH)D) dianalisis menggunakan in-vitro chemiluminescent immunoassay (CLIA). Analisis statistik yang sesuai dilakukan untuk membuktikan tujuan penelitian. Perbandingan nilai median (Q1-Q3) kadar vitamin D pada pasien DM dengan dan tanpa UKD secara berurutan adalah 8,90 ng/mL (6,52-10,90) dan 16,25 ng/mL (13-19,59), serta bermakna secara statistik (p<0,001). Tidak ada korelasi antara durasi UKD dan keparahan UKD berdasarkan skor PEDIS terhadap kadar vitamin D, serta tidak bermakna secara statistik. Hasil pada penelitian ini menunjukkan bahwa kadar vitamin D pada pasien DM dengan UKD lebih rendah dibandingkan pasien tanpa UKD. Namun belum ada bukti yang cukup untuk menyimpulkan bahwa tidak ada korelasi antara durasi UKD dan keparahan UKD berdasarkan skor PEDIS terhadap kadar vitamin D. ......Diabetic foot ulcers (DFU) are chronic wounds in patients with diabetes mellitus (DM). Vitamin D believed have important role in differentiation, proliferation, cell growth, and immune system modulation hence optimal levels are needed for wound healing. Vitamin D deficiency also thought to interfere insulin production and secretion, thereby contributing to DFU chronicity. This study aims to compare vitamin D levels in DM patients with and without DFU; and determine the correlation between DFU duration and severity by PEDIS (perfusion, extension, depth, infection, sensation) score to vitamin D levels. 25-hydroxyvitamin D serum analyzed using in-vitro chemiluminescent immunoassay. Appropriate statistical analysis was done following the study. Comparison of median values ​​(Q1-Q3) vitamin D levels in DM patients with and without DFU were 8.90 ng/mL (6.52-10.90) and 16.25 ng/mL (13-19.59) respectively, and statistically significant (p<0.001). There was no correlation between DFU duration and severity PEDIS score to vitamin D levels, and it was not statistically significant. The results of this study indicate that vitamin D levels in DM patients with DFU are lower than patients without DFU. However, there is not enough evidence to conclude that there is no correlation between DFU duration and severity by PEDIS score to vitamin D levels.