ASUHAN KEPERAWATAN PADA PENDERITA DIABETES MELLITUS DENGAN MASALAH KEPERAWATAN GANGGUAN INTEGRITAS KULIT/JARINGAN

Impaired skin/tissue integrity often occurs in patients with diabetes mellitus with gangrene due to unstable blood glucose levels, which leads to impaired blood circulation and nerve function. This study used a case study method with the aim of providing nursing care to patients with diabetes mellitus with impaired skin/tissue integrity. The case study was conducted from June 2–5, 2026, in the KH. Mas Mansur Ward, Muhammadiyah Ponorogo General Hospital. The assessment revealed a grade 4 gangrenous wound on the big toe and instep of the right foot, with pain, redness, necrotic tissue, pus, an unpleasant odor, cold extremities, a random blood sugar level of 457 mg/dL, and radiological findings of
gangrenous cellulitis. The established nursing diagnosis was impaired skin/tissue integrity related to peripheral neuropathy. Interventions included monitoring wound characteristics and signs of infection, sterile wound care, cleaning necrotic tissue, changing dressings, education, administering a diabetic diet, and collaborative antibiotic therapy and debridement. The evaluation revealed decreased pain, pus, and redness, but skin and tissue damage persisted. Four days of comprehensive nursing care improved the patient's wound condition, indicated by decreased pain, pus, and redness. However, the impaired skin/tissue integrity remained unresolved due to the severity of the gangrene and the patient's clinical condition, which remained stable with a random blood sugar level of 156 mg/dL and hemoglobin of 3.8 g/dL.