Relationship Between Leukocyte, ESR, and CRP Infection Markers with Changes in Wound Wagner 2 and 3 Diabetic Foot Ulcers

Abstract

Introduction: In 2012, the annual incidence rate of diabetic foot ulcers and gangrene are estimated to be around 2-5% of the general population. About 15% of patients with diabetic foot can have an amputation in the lower limb. Diabetic foot is a health problem that is very difficult to cure. This is further exacerbated by severe conditions of infection and disrupt the process of tissue regeneration, so amputation must be done to prevent the spread of infection. Infection that is not well controlled can inhibit all phases of wound healing. This study aimed to know the relationship between laboratory profile and wound healing in diabetic foot ulcer patients. Method: This was a cross-sectional study with research subjects who were diabetic foot ulcer patients who went to the emergency room and the Cipto Mangunkusumo National Hospital polyclinic during August-December 2019. Statistical analysis was performed to see the correlation between changes in infection marker values and changes in the wound area. Results: During the period August 2019 to December 2019, 30 subjects met the inclusion and exclusion criteria. There were 14 subjects (46.77%) male and 16 subjects (53.3%) female. From the diagnosis, there were 20 subjects (66.3%) with ulcer pedis and ten subjects (33.3%) gangrene pedis. From this study, the average and standard deviation of changes in ABI values were 0.9080 ± 0.100, changes in the number of leukocytes amounted to 4899.87 ± 4512.048, changes in ESR values was 1.8333 ± 1.147, changes in CRP values was 2.6500 ± 1.702, changes in wound area was 10.2727 ± 6.512, and albumin was 2.9487 ± 0.392. From the correlative analysis, it was found between changes in the number of leukocytes with changes in wound area (p=0.058, r=0.350), changes in ESR values with changes in wound area (p=0.034, r=0.388), and changes in CRP values with changes in wound area (p=0.008, r=0.477). Conclusion: There was a significant relationship between changes in ESR values and CRP values with moderate correlation strength changes in the wound area. There was no significant relationship between changes in the number of leukocytes with changes in the wound area. Keywords: wound area, leukocytes, CRP, ESR, diabetic foot ulcer, leukocytes.