Efficacy of a Pineapple Core-Based Hand Sanitizer in Reducing Bacterial Contamination and Infection Risk in Diabetic Foot Ulcer Care: A True Experimental Study

Sukron Sukron; Heri  Shatriadi; Indah  Sari; Nichapatr  Phutthikhamin

doi:10.56303/jhnresearch.v5i1.756

Authors

Sukron Sukron Department of Adult Nursing, Universitas Muhammadiyah Ahmad Dahlan Palembang, Indonesia
Heri Shatriadi Department of Environmental Health, Universitas Muhammadiyah Ahmad Dahlan Palembang, Indonesia
Indah Sari Department of Toxicology, Universitas Muhammadiyah Ahmad Dahlan Palembang, Indonesia
Nichapatr Phutthikhamin Department of Adult Nursing, Khon Kaen University, Thailand

Keywords:

Diabetes Mellitus, Diabetic Foot Ulcer, Pineapple Stumps, Hand Sanitizer, Wound Care DFU

Abstract

This study evaluated the efficacy of a natural hand sanitizer derived from pineapple core extract as an alternative to alcohol-based agents for reducing bacterial contamination and infection risk during diabetic foot ulcer (DFU) care. Using a true experimental design, the researchers conducted microbiological assessments of 16 nurse hand swabs and clinical observations of 43 DFU patients between February and April 2025. Microscopic results revealed a significant reduction in bacterial presence: only 18.75% of swabs tested positive for gram-positive cocci with the pineapple-based sanitizer, compared to 68.75% in the control group. Furthermore, clinical findings indicated that 76.74% of patients remained infection-free following wound care procedures employing the extract. The study concludes that pineapple core extract possesses potent antimicrobial and anti-inflammatory properties, largely attributed to the enzyme bromelain, making it a viable, eco-friendly, and cost-effective alternative for infection control in specialized wound care settings

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References

Moschiar Almeida B, Evans R, Kayssi A. Fundamentals of wound care for amputation prevention. Semin Vasc Surg [Internet]. 2025;38(1):54–63. Available from: https://doi.org/10.1053/j.semvascsurg.2025.01.001

Ahmed MM, Ibrahim RM, Younis NM. Diabetic Distress among Patients with Type II: A Descriptive Study. Adv Biomed Res. 2025;14(1):1–4.

Fritz M, Grimm M, Thi H, Hanh M, Koot JAR, Nguyen GH, et al. Effectiveness of community- based diabetes and hypertension prevention and management programmes in Indonesia and Viet Nam : a quasi- experimental study. 2024;

Wellmann IA, Ayala LF, Rodríguez JJ, Guetterman TC. Implementing integrated hypertension and diabetes management using the World Health Organization ’ s HEARTS model : protocol for a pilot study in the Guatemalan national primary care system. Implement Sci Commun [Internet]. 2024;1–15. Available from: https://doi.org/10.1186/s43058-023-00539-8

Fejfarová V, Koliba M, Piťhová P, Flekač M, Prýmková V, Venerová J, et al. Economic burden of podiatric care for diabetic foot ulcers in the Czech Republic: A prospective multicenter study. Diabetes Res Clin Pract. 2025;223(March).

Caruso P, Scappaticcio L, Gicchino M, Castaldo F, Barrasso M, Carbone C, et al. Short-term glucose variability as a determinant of the healing rate of diabetic foot ulcer: A retrospective study. Diabetes Metab Syndr Clin Res Rev [Internet]. 2024;18(3):102990. Available from: https://doi.org/10.1016/j.dsx.2024.102990

Huong AKC, Sukki JM, Ngu XTK. Mobiledfu: Classification of Diabetic Foot Ulcer Infection on the Edge. J Eng Sci Technol. 2025;20(2):577–89.

Sun H, Heng H, Liu X, Geng H, Liang J. Evaluation of the healing potential of short-term ozone therapy for the treatment of diabetic foot ulcers. Front Endocrinol (Lausanne). 2023;14(January):1–9.

Banerjee D, Paul S, Selvan C, Pai S, Nandakumar BS, Mukherjee S, et al. Uncovering the Role of Tertiary Lymphoid Organs in the Inflammatory Landscape: A Novel Immunophenotype of Diabetic Foot Ulcers. J Cell Mol Med. 2025;29(7):1–12.

Najm AMA, Yasir AA. Nurses’ Practices Concerning Infection Control Measures in Intensive Care Units. Iran J War Public Heal. 2024;16(2):175–80.

Jarelnape AA, Ali ZT, Fadlala AA, Sagiron EI, Osman AM, Abdelazeem E, et al. The Influence of Nursing Interventions on Patient Outcomes: A Systematic Review. Saudi J Heal Syst Res. 2023;1–7.

Suarmayasa IN. Pola Kuman Pada Manset Sphygmomanometer : Studi Deskriptif Di Rsd Mangusada. J Ris Kesehat Nas. 2023;7(2):163–8.

R MMM. Assessment of Staff Knowledge and Practices for Nosocomial Infection Control and Prevention. 2024;12(1):159–64.

Li J. Awareness of Nosocomial Infection Prevention and Practices Among Undergraduate Nursing Students. 2024;1(1):33–41.

Wang Y, Wang L, Ma W, Zhao H, Han X, Zhao X. Development of a novel dynamic nosocomial infection risk management method for COVID-19 in outpatient settings. BMC Infect Dis [Internet]. 2024;24(1):1–11. Available from: https://doi.org/10.1186/s12879-024-09058-w

Kahusadi OA, Tumurang MN, Punuh MI. Pengaruh Penyuluhan Kebersihan Tangan terhadap ( Hand Hygiene) Perilaku Siswa SD GMIM 76 Maliambao Kecamatan Likupang Barat Kabupaten Minahasa Utara. J KESMAS. 2018;7(5):1–9.

Hanina, Humaryanto, Gading PW, Aurora WID, Harahap H. Nurul Iman Tentang Infeksi Staphylococcus Aureus Di Kulit Dengan Metode Penyuluhan. Medic. 2022;5(2):426–30.

Bahri S, Ginting Z, Vanesa S, ZA N. Formulasi Sediaan Gel Minyak Atsiri Tanaman Nilam (Pogostemon Cablin Benth) Sebagai Antiseptik Tangan (Hand Sanitizer). J Teknol Kim Unimal. 2021;8(1):87.

Mosayan GA, Hukma S S, Walidah P H H. Pinaplast: Plester Luka dari Ekstrak Bonggol Nanas (Ananas Comosus (L.) Merr.) sebagai Pengobatan Alami Luka Sayat. J Edukasi dan Sains Biol. 2022;4(1):26–33.

Handayani H, Haryanti S, Amri C. Efektivitas Penggunaan Ekstrak Kulit Nanas Madu sebagai Disinfektan Spray terhadap Penurunan Angka Kuman Meja Makan. J Kesehat Lingkung Mandiri. 2024;2(2):19–30.

Muaratan J, Natalia A, Ginting B, Meutia R, Pranita NJ. Aktivitas Nano Spray Gel Ekstrak Kulit Nanas ( Ananas comosus L . ) terhadap Pertumbuhan Bakteri Staphylococcus epidermidis pada Ulkus Diabetes Melitus Secara In Vitro Program Studi Farmasi Klinis , Universitas Prima Indonesia , Medan , Sumatera Utara , I. 2025;3.

Saputra R. Buku Ajar Statistik. Vol. 8, Forum Statistika dan Komputasi. 2016. 1–7 p.

Lubis AW, Maulina J. Pemanfaatan Ekstrak Kulit Nanas (Ananas comosus L.) Dalam Pembuatan Hand Wash Sebagai Antibakteri. BEST J (Biology Educ Sains Technol. 2020;3(1):70–5.

Hayati LN, Tyasningsih W, Praja RN, Chusniati S, Yunita MN, Wibawati PA. Isolation and Identification of Staphylococcus aureus in Dairy Milk of The Etawah Crossbred Goat with Subclinical Mastitis in Kalipuro Village, Banyuwangi. J Med Vet. 2019;2(2):76–82.

Asman, Salnus S, Suswani A, Hasanuddin ARP. Gambaran Telur Cacing Balita Stunting Menggunakan Pewarnaan Antosianin Dari Ekstrak Ubi Ungu Metode Flotasi Di Kabupaten Bulukumba. J TLM Blood Smear. 2020;1(1):6–13.

Rosnawaty R, Suryati Y, Sriati A, Inayah I, Imelisa R. Penurunan Beban Keluarga Dalam Merawat Klien Skizofrenia Melalui Triangle Terapy Di Masa Pandemik Covid-19. J keperawatan jiwa. 2022;10(3):535–44.

Kusumaningrum NSD, Saputri AD, Kusuma H, Erawati M. Karakteristik Diabetic Foot Ulcer (DFU) pada Individu dengan Diabetes Mellitus (DM): Studi Deskripsi – Cross Sectional. J Holist Nurs Sci. 2020;7(2):88–98.

Saputri D, Pratama AA, Iza L, Rohmawati L. Pembuatan Handsanitizer Bahan Alam dari Ekstrak Lidah Buaya dan Daun Sirih. Semin Nas Fis. 2021;174–7.

Listari N, Isviyanti I, Triandini IGAAH. Pembuatan Hand Sanitizer Alami di tengah Upaya Mengatasi Kelangkaan pada Masa Pandemi COVID-19 di SMK Bhakti Kencana Mataram. Lumbung Inov J Pengabdi Kpd Masy. 2020;5(2):34.

Kusdiyah E, Darmawan A, Indah Dewi Aurora W, Irbah ah, Ilmu Kesehatan dan Kedokteran Keluarga Fakultas Kedokteran dan Ilmu Kesehatan Universitas Jambi D. Nomor 3, Halaman 48-52. J Kesehat Masy Indones. 2022;17(September):48.

Lee SH, Kim SH, Kim KB, Kim HS, Lee YK. Factors Influencing Wound Healing in Diabetic Foot Patients. Med. 2024;60(5):1–12.

Fan Z, Huang J, Liu Y, Xie H, Yang Q, Liang Y, et al. Multifactorial analysis of risk factors for foot ulcers in patients with neurovascular complications of diabetes. Front Endocrinol (Lausanne). 2024;15(October):1–9.

Parveen K, Hussain MA, Anwar S, Elagib HM, Kausar MA. Comprehensive review on diabetic foot ulcers and neuropathy: Treatment, prevention and management. World J Diabetes [Internet]. 2025;16(3):100329. Available from: http://www.ncbi.nlm.nih.gov/pubmed/40093290%0Ahttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC11885961

Nur D, Muslim A, Said FM, Nambiar N, Intan N, Husnul H. Comparison Of Wound Healing Process Between Hepar Sulph With Aloe Vera Wound Care Dressing Treatment Among Diabetic Foot Ulcers : A Pilot Study. 2025;3(1):1–7.

Lazzarini PA, van Netten JJ. Best practice offloading treatments for diabetic foot ulcer healing, remission, and better plans for the healing-remission transition. Semin Vasc Surg [Internet]. 2025;38(1):110–20. Available from: https://doi.org/10.1053/j.semvascsurg.2025.01.012

Da Ros R, Assaloni R, Michelli A, Brunato B, Barro E, Meloni M, et al. Burden of Infected Diabetic Foot Ulcers on Hospital Admissions and Costs in a Third-Level Center. Diabetology. 2024;5(2):141–50.