Optimalisasi Dasar Luka Diabetik Kronis dengan MEBO: Studi Kasus
DOI:
https://doi.org/10.0001/nxs4yf98Kata Kunci:
luka diabetik kronis; wound bed preparation; TIME; MEBO; terapi regeneratif; epitelisasiAbstrak
Latar Belakang: Luka diabetik kronis merupakan masalah klinis kompleks karena sering disertai hiperglikemia, infeksi lokal, jaringan nekrotik, biofilm, eksudat berlebih, gangguan angiogenesis, dan kegagalan epitelisasi. Kerangka wound bed preparation berbasis TIME dapat digunakan untuk mengarahkan intervensi secara sistematis, sedangkan Moist Exposed Burn Ointment (MEBO) dilaporkan berperan dalam menjaga kelembapan luka, memodulasi inflamasi, mendukung granulasi, kolagen, angiogenesis, dan re-epitelisasi.
Tujuan: Mendeskripsikan penerapan optimalisasi dasar luka diabetik kronis dengan pendekatan TIME dan penggunaan MEBO sebagai terapi topikal regeneratif pada satu kasus luka ekstremitas bawah.
Metode: Studi kasus deskriptif disusun berdasarkan data klinis dan dokumentasi serial perawatan luka. Pengkajian difokuskan pada ukuran luka, jaringan non-viabel, eksudat, tanda infeksi lokal, undermining, dan perkembangan jaringan granulasi serta epitelisasi. Intervensi meliputi sharp debridement menggunakan curette, cleansing dengan PHMB, aplikasi MEBO sebagai primary dressing, foam dressing sebagai secondary dressing, dan frekuensi perawatan setiap 4 hari.
Hasil: Pasien dengan riwayat diabetes tidak terkontrol mengalami luka kronis ekstremitas bawah pascagatal dan infeksi garukan, dengan GDA awal 420 mg/dL. Ukuran luka awal 20 x 15 cm disertai slough 100%, eksudat purulen banyak, tanda infeksi lokal, dan undermining. Setelah 12 kali perawatan, ukuran luka menurun menjadi 10 x 4 cm. Estimasi luas luka berkurang dari 300 cm² menjadi 40 cm² atau sekitar 86,7%. Dokumentasi serial menunjukkan penurunan slough/nekrosis, dasar luka lebih bersih dan lembap, granulasi merah segar, tanda infeksi aktif tidak tampak, dan tepi luka mulai mengalami epitelisasi.
Kesimpulan: Pendekatan TIME yang dikombinasikan dengan MEBO, cleansing, debridement, dan balutan penyerap mendukung perbaikan dasar luka diabetik kronis pada kasus ini.
Kata Kunci: luka diabetik kronis; wound bed preparation; TIME; MEBO; terapi regeneratif; epitelisasi
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Referensi
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