A Study Assessing Healing of Diabetic Foot Ulcer Before and After Infrared Lamp Therapy Among Patients with Diabetic Foot Ulcer at Gopi Hospital, Salem.

Introduction

The human foot has an intricate structure, like that of the wrist and hand. On average, a person walks 75,000 to 1,00,000 miles in one’s lifetime, and it is not surprising therefore, that the feet undergo stress. If a person with normal sensation feels discomfort in some part of the foot while walking, he will compensate for the same by changing the way his foot touches the ground, transferring the impact and pressure forces to another part of the foot. For people with diabetes, in whom sensation may be diminished or lost, the ordinary act of walking is where many foot problems begin. It has been noted that diabetics can have several medical complications. Diabetic foot ulcer is one of the most devastating complications that lead to suffering, disability, hospitalization, and great expense to both the person and the community.

Objectives

The objectives of the present study were to assess diabetic foot ulcer healing before and after infrared lamp therapy among those with foot ulcer in the experimental group, and to find the significant differences in selected factors regarding diabetic foot ulcer healing, before and after infrared lamp therapy among those with diabetic foot ulcer in the experimental group.

Methods

The present study was conducted to assess diabetic foot ulcer healing before and after infrared lamp therapy among patients presenting with diabetic foot ulcer at Gopi Hospital, Salem, Tamilnadu. The study adopted a pre-experimental research design (with one group pretest and posttest). The tool used to record data was an interview/observational schedule. The ulcer healing status was measured using the modified pressure sore status tool developed by Bates Jenes, a standardized tool. For this study, subjects were selected by convenient sampling method in the experimental group, with a sample size of 30 diabetic foot ulcer patients. The objectives and purpose of the study were explained to study participants and confidentiality was maintained throughout. Pretest diabetic foot ulcer status was observed for all 30 participants and data were collected using interview/observational schedule. Infrared lamp therapy was undertaken in the morning for the experimental group, for 10 minutes and at a distance of 45 cm for a period of 5 days by the investigator. The infrared lamp therapy was performed once in a day. After 5 days, posttest diabetic ulcer status was observed and evaluated in the 30 participants who had completed 5 days of regular exposure.

Results

Data obtained were analyzed based on the objectives and hypothesis of the study, using descriptive and inferential statistics. To compute the data, a master data chart was prepared by the investigator. The analysis of the data is presented as follows -

Section I: Data on demographic variables and health variables of patients with diabetic foot ulcer.

IDDM: Insulin Dependent Diabetes Mellitus; NIDDM: Non-Insulin Dependent Diabetes Mellitus

Table 2 elaborates on the details of health variables such as type of diabetic mellitus, duration of diabetic mellitus, duration of ulcer, type of dressing, nutritional supplement, body mass index and glycosylated hemoglobin levels among study participants with diabetic foot ulcer.

SECTION II: Data on diabetic ulcer healing before and after infrared lamp therapy among patients with diabetic foot ulcer.

Table 3 reveals mean difference and t – value between pretest and posttest results regarding diabetic ulcer healing in the experimental group. The reported mean difference between pretest and the average of posttest ulcer healing score was 8.51 in the experimental group. The obtained t-value = 27.67 (p < 0.01) was highly significant. Therefore, the null hypothesis (H01) was rejected, and the research hypothesis was accepted. It is inferred that diabetic foot ulcer healing was effective after exposure to infrared lamp therapy. Therefore, infrared lamp therapy was found to be effective in the treatment of diabetic foot ulcer.

Figure 1 reveals that mean score in all aspects and measures of ulcer healing status such as, size, depth, edges, necrotic tissue type, exudates type, skin color surrounding tissues, peripheral tissue edema and granulation tissue were found to have improved among diabetic foot ulcer patients who received infrared lamp therapy. The observed mean differences in ulcer healing scores were 0.17, 0.77, 0.84, 0.67, 1.5, 1.63, 1.07, 1.04 and 0.9, respectively.

The computed ‘t’ values t=2.41, t=9.76, t=8.60, t=7.62, t=16.16, t=18.25, t=16.00, t=13.68 and t=16.16 was significant p<0.05. Therefore, the null hypothesis (H01) was rejected, and the research hypothesis (H1 ) was accepted. There was a significant difference in diabetic ulcer healing status scores among diabetic foot ulcer clients before and after infrared lamp therapy. It is inferred that diabetic ulcer healing status score among diabetic foot ulcer patients after infrared lamp therapy was significantly higher. Infrared lamp therapy was found effective in healing of diabetic foot ulcer. Conclusion Considering the above findings, researchers in this study concluded that infrared lamp therapy was effective in healing diabetic foot ulcer. Therefore, infrared lamp therapy should be used as augmented therapy for diabetic foot ulcer.

Conflict of Interest

None.