Woundcare in Geriatrics

Aging affects all phases of wound healing, specifically the rate of cell proliferation, wound tensile strength, collagen deposition and wound contraction. Healing also declines over the years. Though physiologic skin changes play a central role, other problem complicate healing, such as chronic conditions, poor nutrition and medication use.

Understanding Skin Changes

• A geriatric patient's skin tends to be thinner, drier, less vascular and has less subcutaneous tissue than a younger patient's. Skin condition, coloration and associated swelling may very well inhibit wound assessment after a traumatic injury.

Chronic Ulcers

• Elderly patients suffering from chronic medical conditions often have chronic ulcers (wounds). The four most common types are: pressure ulcers (open sores caused by prolonged pressure); ischemic ulcers (caused by blood constriction); neuropathic ulcers (from a disturbance or pathological change in the peripheral nervous system); and venous ulcers (shallow lower-leg wounds that develop when the leg veins fail to return blood to the heart normally). Pressure relief is recommended for pressure ulcers and neuropathic ulcers. Ischemic ulcers require revascularization, and venous ulcers need adequate edema control. All chronic ulcers can heal completely with proper diagnosis and treatment.

Wound Management

• Managing a traumatic wound in a geriatric patient includes taking into consideration the physiological factors of aged skin and the patient's condition. Complete assessment and constant reassessment are vital. Vigilance is required to achieve optimum results, including determining evidence of healing.