WIDASARI SRI GITARJA

- IKRAM BAUK, SULAWESI

INDONESIA
 WOUND
CARE IN
INDONESIA
 FACT
90% of the wounds seen by our service in
Indonesia have Diabetic ulcers.

Most of these patients are diagnosed with Diabetes

when they present with their first Diabetic ulcer.

Most of these patients have poor diabetic control,

people eat a lot of carbohydrates and fat and do not
adhere to a diet.

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 wOuNd CarE UpdAte
Modern wound care
Evidence based on wound management

Old wound care

Traditional wound care
 Promotes wound healing
• Proper wound management
• WOUND CARE
• SAVE DEBRIDMENT : Autolityc, CSWD, cleansing method
with hydro pressure , enzimatyc.
• topical therapy management : MOISTURE BALANCE

• Physical modalities:
• Micro massage surrounding wound location esspecialy in
frozen wound
• Exercising (the proximal & distal structures)
• Infra red expose for wound vascularization
• OZON treatment in wound care
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 CSWD CLEANSING WITH
“HYDROPRESURE”

In wound care setting,

AUTOLYSIS combination of
debridement methods
ENZYMATIC
such as autolysis and
other methods will be
required to support
SAVE
DEBRIDEMENT
WOUND BED PREPARATION
 CSWD, cleansing hydro pressure

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 INFRA RED THERAPY

•MICROMASSAGE
•EXERCISING

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 OZONISASI

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 MOISTURE BALANCE
BEFORE AFTER 10 DAYS

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 CASE : DIABETIC FOOT ULCER

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Mrs. T, 45 years. One month delayed wound healing in hospital with
uncontrolled blood glucose. She rejected for amputation and came to
wound center for other second opinion .

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 She has good motivated to heal. We done prepared the wound bed
until have a good healthy tissue and The wound become smaller .

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 27.02.12 – 24.04.12

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 27.03.09 – 09.06.09

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 11.7.2009 – 18.11.2009

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 31.01.09 – 31.03.09

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 Indonesian ETNEP
PROGRESIF PROGRAM : CERTIFIED WOUND CARE CLINICIAN

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INDONESIA. Consisting of more than 17,000 islands, the vast
Indonesian archipelago spans 5,120 km across the equator, positioned
between the Asian and Australian continents. Four-fifths of the area is
sea with the major islands of Sumatera, Java, Kalimantan (Borneo),
Sulawesi (Celebes) and Papua.

JAKARTA MAJENE
 Community health in Aceh

Transitioning patients into the community following a hospital

stay is very important for the well being of the wound, patient
and family in Indonesia
 Majene - Sulawesi
Case : UNIQUE & DIFFERENT
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Case : UNIQUE & DIFFERENT
Mr. X, 32 yrs. Blood glucose : 400 mg/dl with Non healed abces for 1
month. Pain, anxiety and bad odor

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02.05.12 – 14.05.12

SLOUGH
REMOVE

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 02.03.12 – 15.03.12
GAUZE
INSIDE

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 26.09.12 – 11.11.12 :
STORY : IN HOME CARE SETTING

MAGOT
INSIDE

25
 Pasien usia 36 tahun, telah dirawat di RS. Selama 2 bulan,
diagnosa ulkus arteri dan amputasi , keluar dari Rs dan dirawat
oleh dukun selama 1 bulan,

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Keluarga mengantarkan pasien datang ke klinik dengan
LUKA yang terisi penuh belatung pada luka bagian dalam.

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CSWD : SAVE
DEBRIDMENT

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Ini adalah cara kami membungkus luka dengan tetap
mempertahankan kelembaban optimum pada luka

MOIST DRESSING : GARLIC SALF

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Ini keadaannya setelah kakinya dapat kami selamatkan

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This is ME, MY TEAM AND MY BEST PERCEPTORS at my own clinic in
Majene – Sulawesi. I am so proud as an ET nurse, becuse of their vision
to help patient for better quality of life.SEE YOU IN MENADO–JUNE 2013

31
 SUMMARY
• Chronic wound care management (stage 3 – 4) will
be significant healed for 8 weeks when we could
promote :
• T. Wound bed preparation with excellent method of
debridement at least for 2 weeks
• I. Management systemic support such us infection
and protein support at least for 4 weeks in between
with wound bed preparation.
• M. choose the correct dressing for support
granulation and
• E. choose the correct dressing for support
epithelization for another 2 weeks
• Since 2007 – now, diabetic ulcer
is the highest wound rating that
come to our clinic for other
second opinion.

• And we love to campaign STOP

AMPUTATION, prevent at the
beginning – if you have diabetes.
INDONESIAN WOUND CARE
CLINICIAN
• SINCE 2009

• WITH MORE THAN 700

MEMBERS
 THANK YOU

PLEASE WELCOME AT MENADO, THE PLACE OF FLOWERS – APWC 2 JUNE 2013

 WOCARE CLINIC
JL. KH. SHOLEH ISKANDAR-KOMP. RUKO CIPTA HUSADA NO.2, WOCARE CLINIC- BOGOR JAWA – BARAT.
16165 INDONESIA

Branch : Klinik Siaga Medika - Jakarta, RS Melia Cibubur, RS Perikasih-Menado, Majapahit klinik Mojokerto
e. clinic.wocare@yahoo.co.id; 0251-8312928 or 02518312346 www.wocare-clinic.co.cc ; 08158843528
 REFERENCES

• Srigitarja W, Asmi Ch, et. al. Asuhan Keperawatan • Haddad L, Steven, et.al. AAOS (American
Sistem integument: Makalah pelatihan singkat Academy of Orthopedic Sugeons). October 2007
perawatan luka. Bogor : WOCARE Indonesia www.orthoinfo.org
(2007).
• http://www.foot.com/info
• Sri Gitarja.2011. Perawatan Luka Diabet. Edisi3.
WOCARE publishing.Indonesia
• Comfort Shoe Specialists, 11693 Manchester Rd,
St. Louis, MO 63131
• Bryant A, Ruth, et.al. Acute and Chronic Wounds: www.comfortshoesspecialist.com
Current Management Concepts. 3rd Ed.
Philadelphia: Mosbi Elsevier (2007), p.
• Ferry J, Robert . et.al. www.feetforlife.org.

• Carville, Kerlyn. Wound Care Manual. 3rd Ed.

• Angsko, Arizona. www.footcaredirect.com.WCET
Western Australia: Silver Chain Foundation (1998),
jurnal, Vol 28 No. 2, April-June 2008
p160-200.

• Soegondo Sidartawan, et.al. Penatalaksanaan

Diabetes Militus Terpadu. Ed ke-7. Jakarta: FK-UI.
2007.