Effect of Sea Cucumber on Reducing Periwound Maceration and Inflammation-Related Indicators in Patients with Diabetic Foot Ulcers Indonesia

Haryanto Haryanto, Defa Arisandi, Makoto Oe, Kazuhiro Ogai, Suriadi Suriadi, Mayumi Okuwa, Junko Sugama

= http://dx.doi.org/10.24990/injec.v7i1.504
Abstract views = 5 times | views = 7 times

Abstract


Introduction: Maceration is one of the problems affecting the healing process of diabetic foot ulcers (DFUs).  In complementary therapies, sea cucumber is known to have higher absorbency. However, there are few studies on the reducing of periwound maceration and inflammation-related indicators in DFU.

Methods: This was an observational study at a wound care clinic in Indonesia. Thirty-one DFU patients received treatment with sea cucumber were enrolled in the study. As control samples, 35 DFU patients treated with honey were also included. All were new occurrence DFU and had maceration at the baseline. The maceration area and inflammation-relate indicators including TNF-, MMP-2, and MMP were measured on baseline and week 4.

Results: There were no significant differences between two groups at the baseline.  In the multiple linear regression model, sea cucumber significantly associated with the proportion of maceration reduction than honey at week 4 (β0.520, p=0.001). There were no significant differences between two groups in levels on TNF-α, MMP-2, and MMP at week 4.

Conclusions: Our results demonstrated that sea cucumber might be appropriate for reducing DFU periwound maceration.


Keywords


complementary therapy, diabetic foot ulcer, honey, maceration, sea cucumber

Full Text:

PDF

References


Arisandi, D., Oe, M., Roselyne Yotsu, R., Matsumoto, M., Ogai, K., Nakagami, G., Tamaki, T., Suriadi, Sanada, H., & Sugama, J. (2016). Evaluation of validity of the new diabetic foot ulcer assessment scale in Indonesia. Wound Repair and Regeneration, 24(5), 876–884. https://doi.org/10.1111/wrr.12464

Bakker, K., Apelqvist, J., Lipsky, B. A., Van Netten, J. J., & Schaper, N. C. (2016). The 2015 IWGDF guidance documents on prevention and management of foot problems in diabetes: development of an evidence-based global consensus. Diabetes/Metabolism Research and Reviews, 32(30), 2–6. https://doi.org/10.1002/dmrr.2694

Bordbar, S., Anwar, F., & Saari, N. (2011). High-value components and bioactives from sea cucumbers for functional foods - A review. Marine Drugs, 9(10), 1761–1805. https://doi.org/10.3390/md9101761

Bryant RA (2012). Types of skin damage and differential diagnosis, in R.A. Bryant & D.P. Nix (eds.), Acute and chronic wounds. 4th ed. Elsevier, pp.83-107.

Dong, X., Liu, W., Song, X., Lin, X., Yu, D., Yu, C., & Zhu, B. (2019). Characterization of Heat-Induced Water Adsorption of Sea Cucumber Body Wall. Journal of Food Science, 84(1), 92–100. https://doi.org/10.1111/1750-3841.14392

Gray, M., & Weir, D. (2007). Prevention and Treatment of Moisture-Associated Skin Damage (Maceration) in the Periwound Skin. Journal of Wound, Ostomy & Continence Nursing, 34(2), 153–157. https://doi.org/10.1097/01.WON.0000264827.80613.05

Haryanto, H., Arisandi, D., Suriadi, S., Imran, I., Ogai, K., Sanada, H., Okuwa, M., & Sugama, J. (2017). Relationship between maceration and wound healing on diabetic foot ulcers in Indonesia: a prospective study. International Wound Journal, 14(3), 516–522. https://doi.org/10.1111/iwj.12638

Haryanto, H., Urai, T., Mukai, K., Gontijo Filho, P. P., Suriadi, S., Sugama, J., & Nakatani, T. (2012). Effectiveness of indonesian honey on the acceleration of cutaneous wound healing: an experimental study in mice. Wounds: a compendium of clinical research and practice, 24(4), 110–119. Haryanto, Ogai, K., Suriadi, Nakagami, G., Oe, M., Nakatani, T., Okuwa, M., Sanada, H., Sugama, J. (2018). A prospective observational study using sea cucumber and honey as topical therapy for diabetic foot ulcers in Indonesia. Journal of Wellness and Health Care, 41(2), pp. 41–56.

Li, D., Li, L., Xu, T., Wang, T., Ren, J., Liu, X., & Li, Y. (2018). Effect of Low Molecular Weight Oligopeptides Isolated from Sea Cucumber on Diabetic Wound Healing in db/db Mice. Marine Drugs, 16(1). https://doi.org/10.3390/md16010016

Oyibo, S. O., Jude, E. B., Tarawneh, I., Nguyen, H. C., Harkless, L. B., & Boulton, A. J. M. (2001). A Comparison of Two Diabetic Foot Ulcer Classification Systems. Diabetes Care, 24(1), 84–88. https://doi.org/10.2337/diacare.24.1.84

Pangestuti, R., & Arifin, Z. (2018). Medicinal and health benefit effects of functional sea cucumbers. Journal of Traditional and Complementary Medicine, 8(3), 341–351. https://doi.org/10.1016/j.jtcme.2017.06.007

Patel, S., Maheshwari, A., & Chandra, A. (2016). Biomarkers for wound healing and their evaluation. Journal of Wound Care, 25(1), 46–55. https://doi.org/10.12968/jowc.2016.25.1.46

Poh Yuen Wen, A., Halim, A. S., Mat Saad, A. Z., Mohd Nor, F., & Wan Sulaiman, W. A. (2018). A prospective study evaluating wound healing with sea cucumber gel compared with hydrogel in treatment of skin graft donor sites. Complementary Therapies in Medicine, 41, 261–266. https://doi.org/10.1016/j.ctim.2018.10.006

Prompers, L., Schaper, N., Apelqvist, J., Edmonds, M., Jude, E., Mauricio, D., Uccioli, L., Urbancic, V., Bakker, K., Holstein, P., Jirkovska, A., Piaggesi, A., Ragnarson-Tennvall, G., Reike, H., Spraul, M., Van Acker, K., Van Baal, J., Van Merode, F., Ferreira, I., & Huijberts, M. (2008). Prediction of outcome in individuals with diabetic foot ulcers: Focus on the differences between individuals with and without peripheral arterial disease. The EURODIALE Study. Diabetologia, 51(5), 747–755. https://doi.org/10.1007/s00125-008-0940-0

Saeedi, P., Petersohn, I., Salpea, P., Malanda, B., Karuranga, S., Unwin, N., Colagiuri, S., Guariguata, L., Motala, A. A., Ogurtsova, K., Shaw, J. E., Bright, D., & Williams, R. (2019). Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Research and Clinical Practice, 157, 107843. https://doi.org/10.1016/j.diabres.2019.107843

Vandamme, L., Heyneman, A., Hoeksema, H., Verbelen, J., & Monstrey, S. (2013). Honey in modern wound care: A systematic review. Burns, 39(8), 1514–1525. https://doi.org/10.1016/j.burns.2013.06.014

Voegeli, D. (2012). Moisture-associated skin damage: aetiology, prevention and treatment. British Journal of Nursing, 21(9), 517–521. https://doi.org/10.12968/bjon.2012.21.9.517

White, R. J., & Cutting, K. F. (2003). Interventions to avoid maceration of the skin and wound bed. British Journal of Nursing, 12(20), 1186–1201. https://doi.org/10.12968/bjon.2003.12.20.11841

Yusuf, S., Okuwa, M., Irwan, M., Rassa, S., Laitung, B., Thalib, A., Kasim, S., Sanada, H., Nakatani, T., & Sugama, J. (2016). Prevalence and Risk Factor of Diabetic Foot Ulcers in a Regional Hospital, Eastern Indonesia. Open Journal of Nursing, 06(01), 1–10. https://doi.org/10.4236/ojn.2016.61001

Zohdi, R. M., Zakaria, Z. A. B., Yusof, N., Mustapha, N. M., & Abdullah, M. N. H. (2011). Sea cucumber (Stichopus hermanii) based hydrogel to treat burn wounds in rats. Journal of Biomedical Materials Research - Part B Applied Biomaterials, 98 B(1), 30–37. https://doi.org/10.1002/jbm.b.31828


Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This journal is indexed by:

 


 

Creative Commons License

Copyright of Indonesian Nursing Journal of Education and Clinic (INJEC) (e-ISSN:2527-8819, p-ISSN:2527-8800).


View My Stats