Online ISSN: 2515-8260

Keywords : diabetic ulcer

DMIST Scale for Predicting Healing Time within 12 Weeks in Patients with Diabetic Ulcer

Suriadi, RN, Ph.D, AWCS; Wida Kuswida Bhakti, RN, Ph.D

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 2285-2293

Background: An assessment scale, namely, the DMIST (deep, moisture, infection/inflammation, size, tissue type of wound bed, type of wound edge and tunnelling/undermining), was designed to identify the healing time of chronic ulcers. An evaluation was then conducted to test the predictive validity of DMIST. This study aimed to evaluate whether the total scores from the DMIST scale could predict healing time of diabetic ulcer.
Method: A prospective study cohort was obtained from the Kitamura Wound Clinic in Pontianak, Indonesia. A total of 33 patients with diabetic ulcer were recruited to participate in the study. Collected data included DMIST score, demographic information, Wagner wound classification, neuropathic status, ankle brachial index, HbA1c level and wound images. Using the DMIST scale, trained data collectors scored patients every 7 days until ulcers were healed or patients were discharged.
Results: A cutoff score of 9 was valid as a predictor of non-healing after 12 weeks. The DMIST scale was found to have high sensitivity (90%) and specificity (96%). The area under the receiver operating characteristic curve was 0.98 (95% confidence interval, 0.856 to 1.000).
Conclusion: The DMIST scale was found to be a valid assessment scale to identify wound healing time in a period of 12 weeks in patients with diabetic ulcer.

An Appearance Characteristic Ulcer In Diabetic Patients At Kitamura Clinic In Pontianak, Indonesia

Suriadi AWCS, CFCN, Ph.D

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 3436-3444

Background: There are several types of diabetic foot ulcers, namely neuropathic, ischemic, neuro-ischemic, mix ulcer, diabetic bullae, and furuncle/carbuncle. This study intends to identify the characteristics of ulcers in diabetic patients.
Methods: A cross-sectional study was conducted in Kitamura Wound Clinic, in Pontianak-Indonesia from October 2019 to February 2020 to investigate ulcer occurrence in diabetic patients. A sample was used to select 292 study participants. A univariate model analysed the characteristic respondent and ulcers.
Results: The median and range age of the participants was 56 (27-87) years, and 55.1% of the participants were female. The patients with positive neuropathy were 30.8%, the mean of systole blood pressure was 135.68 (±23.9) and diastolic pressure was 83.02 (±11.4). The median and range of HbA1C were 9.8 (6.44 -14). Characteristics of ulcer in diabetic included 36% DUDT (diabetic ulcer due to trauma), 37.3% diabetic bullae, 9.2% furuncle/carbuncle (boils), and 8.6% neuropathic. The most common cause of ulcers was trauma (47.9%) and the most common ulcer locations were 38.4% on the toe and plantar (24.7%).
Conclusion: This study found the characteristics of ulcers in diabetic patient were DUDT, neuropathic, ischemic, neuro-ischemic, arterial, venous, mixed ulcer, diabetic bullae and furuncle/carbuncle. Health care providers should distinguish the types or characteristics of ulcers in diabetic patients so that they can consider wound care and treatment according to the characteristics of diabetic ulcers.