Prediction of Wound Healing in Diabetic Foot Ulcers: an Observational Study in Tertiary Hospital in Indonesia
Abstract: to evaluate the role
of clinical characteristics, functional markers of vasodilation, inflammatory
response, and atherosclerosis in predicting wound healing in diabetic foot
ulcer. Methods: a cohort study (February – October 2010) was conducted from 40
subjects with acute diabetic foot ulcer at clinical ward of Dr. Cipto
Mangunkusumo National Central General Hospital, Jakarta, Indonesia. Each
subject underwent at least two variable measurements, i.e. during inflammatory
phase and proliferation phase. The studied variables were clinical
characteristics, complete peripheral blood count (CBC) and differential count,
levels of HbA1c, ureum, creatinine, lipid profile, fasting blood glucose (FBG),
marker of endothelial dysfunction (asymmetric dimethylarginine/ADMA,
endothelin-1/ET-1, and flow-mediated dilation/FMD of brachial artery), and
marker of vascular calcification (osteoprotegerin/OPG). Results: median of time
achieving 50% granulation tissue in our study was 21 days. There were nine
factors that contribute in the development of 50% granulation tissue, i.e.
family history of diabetes mellitus (DM), previous history of wound, wound
area, duration of existing wound, captopril and simvastatin medications, levels
of ADMA, ET-1, and OPG. There were three out of the nine factors that
significantly correlated with wound healing, i.e. wound area, OPG levels, and
simvastatin medications. Conclusion: in acute diabetic foot ulcers, wound area
and OPG levels had positive correlation with wound healing, whereas simvastatin
medications had negative correlation with wound healing.
Keywords: diabetic ulcer;
wound healing; endothelial dysfunction; vascular calcification
Author: Pradana Soewondo,
Slamet Suyono, Mpu Kanoko Sastrosuwignyo, Alida R Harahap, Bambang Sutrisna,
Lukman H Makmun
Journal Code: jpkedokterangg170341
