A Wound Treatment Strategy for “Super Long-Term Difficult-to-Heal Wounds”: A Single-Center Retrospective Study

2020 ◽  
pp. 153473462096029
Author(s):  
Chunjiang Ye ◽  
Yuanhai Zhang ◽  
Chunmao Han ◽  
Shulei Mao ◽  
Liangfang Ni ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Chronic Wounds ◽  
Wound Infection Rate ◽  
Healing Time ◽  
High Survival ◽  
Wound Area ◽  
Suitable Treatment ◽  
Average Total Number ◽  
Wound Healing Time

Chronic wounds are a challenge for clinicians. Treating chronic wounds in elderly patients is difficult due to comorbidities and poor immunity, tissue renewal, and regeneration. This study shared the therapeutic experiences of 40 patients with super long-term difficult-to-heal wounds and to describe the effects of negative pressure wound therapy (NPWT)-assisted debridement and autologous scalp grafting. Elderly patients with chronic wounds for more than 60 years who underwent NPWT-assisted debridement and autologous scalp grafting between 2015 and 2017 were retrospectively analyzed. Forty patients were identified and analyzed. Among all patients, the average wound area was 56 (interquartile range 30-90) cm2. The wound infection rate was 82.1%, and that before the first autologous scalp grafting was 51.3%. The average total number of surgeries was 3, and the number of times the NPWT device was replaced was once. A total of 97.4% of patients had one autologous scalp grafting performed. The transplanted scalp survived completely in 97.4% of patients. One hundred percent of patients had no postoperative complications and healed. The average wound healing time was 34.5 ± 10.1 days. This study showed that NPWT-assisted debridement and autologous scalp grafting have the advantages of high survival rate of the skin and decreased wound recurrence and may be a suitable treatment for super long-term difficult-to-heal wounds in elderly patients.

scholarly journals Assessment of Frailty In Elderly Patients Attending A Multidisciplinary Wound Care Center: A Cohort Study.

2021 ◽  
Author(s):  
Mariona Espaulella-Ferrer ◽  
Joan Espaulella-Panicot ◽  
Rosa Noell-Boix ◽  
Marta Casals-Zorita ◽  
Marta Ferrer-Sola ◽  
...  
Keyword(s):  
Wound Healing ◽  
Elderly Patients ◽  
Healing Rate ◽  
Wound Care ◽  
Frailty Index ◽  
Healing Time ◽  
Venous Ulcers ◽  
Healing Wounds ◽  
Wound Healing Time ◽  
The Relationship

Abstract Background: The incidence of frailty and chronic wounds increases with patients’ age. Knowledge of the relationship between frailty and wound healing progress is greatly lacking. Methods: The aim of this study is to characterize the degree of frailty in elderly patients attending a multidisciplinary wound care centers (MWCC). Additionally, we seek to assess the impact of frailty on the wound healing rate and wound healing time. An open cohort study was conducted on 51 consecutive patients aged > 70 years treated for wounds at an MWCC of an intermediate care hospital. The frailty score was determined according to the Frail-VIG index. Data were collected through patient questionnaires at the beginning of the study, and at six months or upon wound healing. Wounds were followed up every two weeks. To analyze the relationship between two variables was used the Chi-square test and Student’s or the ANOVA model. The t-test for paired data was used to analyze the evolution of the frailty index during follow-up.Results: A total of 51 consecutive patients were included (aged 81.1 ± 6.1 years). Frailty prevalence was 74.5% according to the Frail-VIG index (47.1% mildly frail, 19.6% moderately frail, and 7.8% severely frail). Wounds healed in 69.6% of cases at six months. The frailty index (FI) was higher in patients with non-healing wounds in comparison with patients with healing wounds (IF 0.31 ± 0.15 vs IF 0.24 ± 0.11, p=0.043). A strong correlation between FI and wound healing results was observed in patients with non-venous ulcers (FI 0.37 ± 0.13 vs FI 0.27 ± 0.10, p=0.015). However, no correlation was observed in patients with venous ulcers (FI 0.17 ± 0.09 vs FI 0.19 ± 0.09, p=0.637). Wound healing rate is statically significantly higher in non-frail patients (3,26% wound reduction/day, P25-P75 0.8-8.8%/day) in comparison with frail patients (8.9% wound reduction/day, P25-P75 3.34-18.3%/day; p=0.044). Conclusion: Frailty is prevalent in elderly patients treated at an MWCC. Frailty degree is correlated with wound healing results and wound healing time.

Comparison of Efficacy of Unna’s boot and Ozone therapy on Chronic Venous Leg Ulcers: a series of case

2020 ◽  
Vol 9 (9) ◽  
pp. e44996967
Author(s):  
Denise Viviane Ferreira Del Castilo ◽  
Marcello Magri Amaral ◽  
Carla Roberta Tim ◽  
Cintia Cristina Santi Martignago ◽  
Daniela Bezerra Macedo ◽  
...  
Keyword(s):  
Wound Healing ◽  
Treatment Group ◽  
Chronic Wounds ◽  
Healing Time ◽  
Ozone Treatment ◽  
Leg Ulcers ◽  
Ozone Therapy ◽  
Venous Leg Ulcers ◽  
Wound Healing Time ◽  
Tissue Reduction

The aim of this study was to evaluate and compare the effectiveness of Unna’s boot and ozone therapy on chronic venous leg ulcers. Seven patients with chronic venous leg ulcers were taken into the study and were randomly divided into two groups: Unna’s boot treatment group (BU); Ozone treatment group (OZ). The therapies were performed weekly until wound closure. The morphological descriptive results demonstrated that during the treatments, it was possible to observe the presence of semi-planar borders, granulation tissue, reduction of edema, fibrin and exudate and absence of odor. These morphological modifications were more pronounced in the OZ when compared to the BU. Furthermore, both treatments promoted the same wound healing time, never the less the ozone therapy produced a higher percentage of weekly wound reduction compared to Unna's boot. Unna's boot and ozone therapy treatments appeared to positively impact the course of wound healing in chronic wounds, however the ozone therapy may improve the healing of chronic venous leg ulcers in a higher weekly percentage.

scholarly journals Assessment of frailty in elderly patients attending a multidisciplinary wound care centre: a cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mariona Espaulella-Ferrer ◽  
Joan Espaulella-Panicot ◽  
Rosa Noell-Boix ◽  
Marta Casals-Zorita ◽  
Marta Ferrer-Sola ◽  
...  
Keyword(s):  
Wound Healing ◽  
Elderly Patients ◽  
Healing Rate ◽  
Wound Care ◽  
Frailty Index ◽  
Healing Time ◽  
Venous Ulcers ◽  
Healing Wounds ◽  
Wound Healing Time ◽  
The Relationship

Abstract Background The incidence of frailty and non-healing wounds increases with patients’ age. Knowledge of the relationship between frailty and wound healing progress is greatly lacking. Methods The aim of this study is to characterize the degree of frailty in elderly patients attending a multidisciplinary wound care centres (MWCC). Additionally, we seek to assess the impact of frailty on the wound healing rate and wound healing time. An open cohort study was conducted on 51 consecutive patients aged > 70 years treated for wounds at an MWCC of an intermediate care hospital. The frailty score was determined according to the Frail-VIG index. Data were collected through patient questionnaires at the beginning of the study, and at 6 months or upon wound healing. Wounds were followed up every 2 weeks. To analyse the relationship between two variables was used the Chi-square test and Student’s or the ANOVA model. The t-test for paired data was used to analyse the evolution of the frailty index during follow-up. Results A total of 51 consecutive patients were included (aged 81.1 ± 6.1 years). Frailty prevalence was 74.5% according to the Frail-VIG index (47.1% mildly frail, 19.6% moderately frail, and 7.8% severely frail). Wounds healed in 69.6% of cases at 6 months. The frailty index (FI) was higher in patients with non-healing wounds in comparison with patients with healing wounds (IF 0.31 ± 0.15 vs IF 0.24 ± 0.11, p = 0.043). A strong correlation between FI and wound healing results was observed in patients with non-venous ulcers (FI 0.37 ± 0.13 vs FI 0.27 ± 0.10, p = 0.015). However, no correlation was observed in patients with venous ulcers (FI 0.17 ± 0.09 vs FI 0.19 ± 0.09, p = 0.637). Wound healing rate is statically significantly higher in non-frail patients (8.9% wound reduction/day, P25-P75 3.34–18.3%/day;AQ6 p = 0.044) in comparison with frail patients (3.26% wound reduction/day, P25-P75 0.8–8.8%/day). Conclusion Frailty is prevalent in elderly patients treated at an MWCC. Frailty degree is correlated with wound healing results and wound healing time.

scholarly journals Chronic dialysis in patients over age 65.

1996 ◽  
Vol 7 (5) ◽  
pp. 637-646
Author(s):  
D L Latos
Keyword(s):  
Elderly Patients ◽  
The Elderly ◽  
The United States ◽  
Cardiovascular Complications ◽  
Treatment Modalities ◽  
Additional Time ◽  
Access Problems ◽  
Suitable Treatment ◽  
Group Survival

In the United States, persons over the age of 65 are expected soon to become the majority of those people who will require maintenance dialysis therapy. Many of these individuals have numerous comorbid medical complications, which, together with altered physiologic adaptation related to aging, create a great challenge for the nephrologist. Despite a considerably lower group survival rate and increased hospitalization utilization as compared with younger patients, many elderly dialysis patients tolerate therapy very well and appear quite satisfied with the quality of their lives. Both hemodialysis and peritoneal dialysis are suitable treatment modalities for elderly patients, but recommendations regarding type of dialysis must be individualized, taking both medical and psychosocial issues into consideration. Vascular access problems are particularly important for the elderly and contribute to significant morbidity. Malnutrition and cardiovascular complications also require special attention. Withdrawal from dialysis appears to be increasingly common among elderly ESRD patients and highlights the need for the completion of advance directives. A trial of dialysis may allow elderly patients and their families additional time to decide whether long-term dialysis is deemed appropriate.

scholarly journals Short Implants in Posterior Maxilla in Elderly Patients: A Case Series

2019 ◽  
Vol 53 (5) ◽  
Author(s):  
David Buntoro Kamadjaja
Keyword(s):  
Elderly Patients ◽  
Case Series ◽  
Short Implants ◽  
Posterior Maxilla ◽  
Long Term Follow Up ◽  
Suitable Treatment ◽  
Maxillary Sinus Floor ◽  
Sinus Floor

Placement of dental implants in reduced bone in the posterior maxilla requires maxillary sinus floor elevation. However, in elderly patients this is to be avoided. A case series on the successful placement of multiple short implants in posterior maxilla and splinted crown restorations in elderly patients was presented. Long term follow up revealed survival of the implants. Short implant is a suitable treatment option for elderly patients.

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