Post on 13-Apr-2015
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
AngiopatiPeripheral vascular disease causes poor blood flow in the arms and legsthat can affect the ability of a sore or cut to heal, leading to ulcers or gangrene
PATOFISIOLOGI
NeuropatiDiabetic 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 well-fitting shoes.
PROGNOSIS
Part of the body affected
The extent of gangrene
The cause of gangrene
The overall health status of the individual
T E R I M A K A S I H