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Meirizal Hasan
Department Of Orthopaedic And Traumatology, Sardjito General Hospital/ Faculty Of Medicine, Public Health And Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
Medicine & Pharmacology

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Clinical Correlates of the Severity of Diabetic Foot Ulcers Rahadyan Magetsari; Meirizal Hasan; Yossie Atyandhari
Journal of Global Pharma Technology Volume 12 Issue 06 (2020) June 2020
Publisher : Journal of Global Pharma Technology

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Abstract

OBJECTIVE Severe diabetic foot ulcer leads to amputation and is associated with higher risk of mortality. The purpose of this study is to identify clinical correlates of severe diabetic foot ulcers. METHODS The design of the study was cross-sectional survey of medical records on patients treated in Sardjito Hospital from 1 January to 31 July, 2014. Severe foot ulcer was measured as grade 4 and 5 according to Wagner classification. ABI (Ankle Brachial Index) to estimate blood flow to lower extremities and Semmes-Weinstein test using monofilament to detect neuropathy, classified as positive or negative, were done in all patients. HbA1C, serum sodium and creatinine levels were measured during the latest hospital visit. RESULTS The results of this study showed that 77 (36.5%) among 211 patients had severe foot ulcers (grade 4 and 5, Wagner classification). ABI and Semmes-Weinstein monofilament test failed to predict severity of diabetic foot ulcers. HbA1c increased the odds of severe ulcers while higher serum sodium level and higher diastolic blood pressure protected patients against severe ulcers. CONCLUSION Better glycemic control and caution against excessive reduction of diastolic blood pressure, usually due to anti-hypertension medication, should be recommended to prevent the development of severe foot ulcer. KEYWORDS: diabetic foot ulcers, severity, glycemic control, hypertension, poor circulation, neuropathy
Reconstruction of A Huge Soft Tissue Deffect in Flank Region Using Rectus Femoris Flap Meirizal Hasan; Rahadyan Magetsari; Rezky Saraswaty
Journal of Global Pharma Technology Volume 13 Issue 04 (2021) April 2021
Publisher : Journal of Global Pharma Technology

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Abstract

Introduction:Coverage of full-thickness large flank defect is a challenging procedure for surgeons. The rectus femoris (RF) muscle flap is an excellent donor muscle for many reconstructions. The vascularized rectus femoris (RF) muscle flap has been proved to be effective to cover infected vascular grafts in the flank region. Outcome of the treatment can be evaluated by evaluating the patient daily activity. Case Report:This was a case report conducted on patient with huge soft tissue deffect in flank region. A 62 years old male with large defect of the right flank region due to infection of the abdominal cavity after appendectomy 2 months ago. The wound size 15 x 7 x 7 cm, with the base is bowel, with serohemoragic discharge. Then perform debridement and rectus femoris flap. A month after operation, the patient came to the Sardjito General Hospital with defect of the right hypogastric region and then VAC was performing in this patient. Two month after VAC, the wound was covered by granulating tissue and then the patient underwent FTSG. A month after the second operation, the patient came to outpatient clinic, able to walk, with the condition of the wound was good, no visible sign of infection. Conclusion:From this case report shows that rectus femoris flap has a good result to coverage the huge soft tissue defect in flank region. The patient can perform a simple daily living. Keywords: Rectus femoris, Flank defect, Flap.
Co-Authors Rahadyan Magetsari Rezky Saraswaty Yossie Atyandhari