GANGREN DIABETIKUM

Oleh:

Asmaul Husna
Nurul Fitria Nurul Hidayah Ridza Wisda A

Rizkya Ika Fadilla

Pembimbing: dr Yopie A. Habibie, Sp.BTKV

DEFINISI

Gangren : kematian jaringan oleh karena terhentinya suplai darah ke jaringan tersebut dikarenakan berbagai proses seperti infeksi, penyakit vaskular dan trauma.

Gangren diabetikum : gangren yang dijumpai pada penderita DM. Gangren diabetik merupakan dampak jangka lama arteriosclerosis dan emboli trombus kecil.

KLASIKIFASI
1.

Gangren kering Disebabkan penurunan blood flow melalui arteri Jaringan dingin dan hitam > mengering > mengelupas Penyebab: arteriosklerosis

KLASIFIKASI
2.

Gangren Basah Komplikasi luka infeksi Infeksi > swelling > hambatan blood flow Gas gangrene is a type of wet gangrene caused by the bacteria known as Clostridia. Clostridia are a type of infection-causing bacteria that grow only in the absence of oxygen. As Clostridia grow, they produce poisonous toxins and gas; therefore, the condition is called gas gangrene.

GEJALA

Area yang terkena menjadi dingin dan mati rasa

Pada awal mula gangren:

Merah

(Diskolorasi) Coklat

Hitam

GEJALA

Dry gangrene:

The affected area becomes cold and numb. Initially, the affected area becomes red. Then, it develops a brown discoloration. Finally, it becomes black and shriveled.

GEJALA

Wet or moist gangrene:

The affected area becomes swollen and decays.

It is extremely painful.

Local oozing occurs.

It produces a foul-smelling odor. It becomes black. The affected person develops a fever.

GEJALA

Gas gangrene: The wound is infected.

A brown-red or bloody discharge may ooze from the affected tissues. Gas produced by Clostridia may produce a crackling sensation when the affected area is pressed. It becomes swollen. Pain in the affected area is severe. The affected person develops fever, increased heart rate, and rapid breathing if the toxins spread into the bloodstream.

PATOFISIOLOGI

Diabetes mellitus > angiopati & neuropati Angiopati Peripheral vascular disease causes poor blood flow in the arms and legs that can affect the ability of a sore or cut to heal, leading to ulcers or gangrene

PATOFISIOLOGI

Neuropati Diabetic neuropathy is a lack of feeling accompanied by tingling, burning, pain, or numbness in your legs and feet due to nerve damage.

DIAGNOSIS Berdasarkan Riwayat penyakit Luka, penyakit kronis (spt diabetes), merokok Pemeriksaan fisik Tes darah Arteriogram Memvisualisasikan obstruksi dari arteri yang memperdarahi daerah yang terkena

PENATALAKSANAAN

Dry gangrene: Because the cause of dry gangrene is a lack of blood flow, restoring the blood supply is vital. Assessment by a vascular surgeon can help determine whether surgical intervention to restore blood supply would be beneficial. Wet gangrene: Surgical debridement (removal of dead tissue) of the wound is performed, and intravenous antibiotics are administered to control the infection.

PENATALAKSANAAN
Antibiotics are usually administered intravenously to control the infection. Pain relievers are administered as necessary. Anticoagulants are administered to prevent blood clotting. Intravenous fluids are administered to replenish electrolytes.

PENATALAKSANAAN Surgery The wound is cleared of dead tissue (debrided) to allow healing and to prevent the spread of infection to surrounding areas. If the infection cannot be controlled with debridement and administration of antibiotics, amputation of the affected part becomes necessary to prevent further deterioration.

PENATALAKSANAAN Hyperbaric oxygen is delivered through a specially designed chamber that contains oxygen under high pressure. Hyperbaric oxygen has been shown in some studies to improve wound healing, and it ensures that bacteria that thrive only in an oxygen-free environment (anaerobic bacteria) will be killed. People receiving hyperbaric oxygen therapy must be monitored for symptoms of oxygen toxicity, such as profuse sweating, difficulty breathing, and convulsions

FOLLOW UP

Keep the affected area clean. Follow the health-care provider's instructions regarding changing bandages and dressings.

Be sure to complete the antibiotic course that is prescribed.

Limit activity as much as possible for a few days.

PENCEGAHAN

Keep wounds clean and sterile Watch for signs of infection (pus, redness, swelling, or unusual pain) People with diabetes should control their blood-sugar levels with proper medication. Education about proper foot care is vital for people with diabetes. They should routinely examine their feet for any signs of injury or change in skin color. Any small injury should be immediately cared for. They should keep their nails trimmed and wear comfortable wellfitting shoes.

PROGNOSIS

Part of the body affected The extent of gangrene The cause of gangrene The overall health status of the individual

TERIMA KASIH