Chronic wound treatment in elderly and geriatric patients

Phlebologie ◽  
2017 ◽  
Vol 46 (04) ◽  
pp. 214-220
Author(s):  
P. Waldhausen ◽  
H.-J. Hermanns
Keyword(s):  
Wound Healing ◽  
Geriatric Patients ◽  
Chronic Wounds ◽  
Wound Care ◽  
Neurological Diseases ◽  
The Elderly ◽  
Ageing Population ◽  
Medical Department ◽  
Continuous Increase ◽  
Skin Conditions

SummaryIn Germany, there has been a continuous increase in life expectancy for more than 135 years. The number of people aged 80 years and over will triple until 2050. Chronic wounds in different aetiologies will increase in our ageing population, with a parallel growth in numbers of comorbidities and geriatric syndromes. Beside vascular difficulties of wound healing and physiological changes in skin conditions among the elderly, we are challenged by the treatment of comorbidities such as diabetes mellitus, neurological diseases (Polyneuropathy), the decrease of mobility and the increase of joint troubles, as well as cognitive, emotional and motoric deficits and even dementia. On the basis of the expected progress in age, we have selectively analysed our patients from the age of 80 up to the age of 100 years with chronic wounds, leg and foot ulcers, treated in a specialised wound care centre. Further, we performed a statistical evaluation for the geriatric medical department with focus on geriatric patients with additional wound-healing problems.

New tools in wound care to support evidence-based best practice

2020 ◽  
Vol 25 (3) ◽  
pp. S26-S29
Author(s):  
Melanie Lumbers
Keyword(s):  
Wound Healing ◽  
Best Practice ◽  
Chronic Wounds ◽  
Wound Care ◽  
Wound Management ◽  
Evidence Based ◽  
Ageing Population ◽  
Positive Outcomes ◽  
Technological Advances ◽  
Management Concepts

Throughout history, various wound healing and management concepts have been recorded, with some approaches such as honey, silver and larvae still in use and others such as blood-letting completely dismissed. In more recent times, dressing products have begun evolving, moving on from basic first-aid supplies to products that support positive healing by addressing the needs of the wound bed and considering underlying factors that impact healing. With an ageing population, the incidence of chronic wounds is predicted to rise, and chronic wounds can negatively impact the lives of patients physically, emotionally and financially. Clinicians continue to explore and review new approaches surrounding the management of wounds, as it is imperative that clinicians use technological advances in wound management alongside established gold standard evidence-based practice to achieve positive outcomes for patients experiencing delayed or challenging wound healing.

Wound Healing in the Golden Agers: What We Know and the Possible Way Ahead

2021 ◽  
pp. 153473462110378
Author(s):  
Aakansha Giri Goswami ◽  
Somprakas Basu ◽  
Vijay Kumar Shukla
Keyword(s):  
Wound Healing ◽  
Chronic Wounds ◽  
Wound Care ◽  
Financial Burden ◽  
Healing Process ◽  
The Elderly ◽  
Wound Healing Process ◽  
Impaired Wound Healing ◽  
Age Related

While “population aging” is an accomplishment that deserves acclamation, it is in itself a tremendous challenge. Age-related skin changes, impaired wound healing, and concurrent comorbidities are the deadly triad that contribute most to the development of nonhealing chronic wounds in the elderly. This imposes enormous medical, social, and financial burden. With the rising trend in the aging population, this problem is likely to exacerbate unless multidisciplinary, rapt wound care strategies are developed. The last decade was dedicated to understand the basic biology underlying the wound healing process but most in vitro and animal model studies translated poorly to human conditions. Forthcoming, the focus is on the development of diagnostic and therapeutic strategies to improve healing in this vulnerable age group. Further, understanding the complex pathobiology of cellular senescence and wound healing process is required to develop focused therapy for these “problem wounds” in the elderly.

scholarly journals Wound dressings: curbing inflammation in chronic wound healing

2021 ◽  
Author(s):  
Davide Vincenzo Verdolino ◽  
Helen A. Thomason ◽  
Andrea Fotticchia ◽  
Sarah Cartmell
Keyword(s):  
Wound Healing ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Healing Process ◽  
Standard Of Care ◽  
The Elderly ◽  
Wound Dressings ◽  
Wound Healing Process

Chronic wounds represent an economic burden to healthcare systems worldwide and a societal burden to patients, deeply impacting their quality of life. The incidence of recalcitrant wounds has been steadily increasing since the population more susceptible, the elderly and diabetic, are rapidly growing. Chronic wounds are characterised by a delayed wound healing process that takes longer to heal under standard of care than acute (i.e. healthy) wounds. Two of the most common problems associated with chronic wounds are inflammation and infection, with the latter usually exacerbating the former. With this in mind, researchers and wound care companies have developed and marketed a wide variety of wound dressings presenting different compositions but all aimed at promoting healing. This makes it harder for physicians to choose the correct therapy, especially given a lack of public quantitative data to support the manufacturers’ claims. This review aims at giving a brief introduction to the clinical need for chronic wound dressings, focusing on inflammation and evaluating how bio-derived and synthetic dressings may control excess inflammation and promote healing.

Effectiveness of biofilm‐based wound care system on wound healing in chronic wounds

2019 ◽  
Vol 27 (5) ◽  
pp. 540-547 ◽  
Author(s):  
Yukie Mori ◽  
Gojiro Nakagami ◽  
Aya Kitamura ◽  
Takeo Minematsu ◽  
Mikio Kinoshita ◽  
...  
Keyword(s):  
Wound Healing ◽  
Chronic Wounds ◽  
Wound Care ◽  
Care System

Identifying New Pathways and Targets for Wound Healing and Therapeutics from Natural Sources

2021 ◽  
Vol 18 ◽  
Author(s):  
Xinchi Feng ◽  
Jinsong Hao
Keyword(s):  
Wound Healing ◽  
Molecular Mechanisms ◽  
Chronic Wounds ◽  
Wound Care ◽  
Healing Process ◽  
Unmet Need ◽  
Wound Dressings ◽  
Wound Healing Process ◽  
Natural Sources ◽  
Viable Approach

: Chronic wounds remain a significant public problem and the development of wound treatments has been a research focus for the past few decades. Despite advances in the products derived from endogenous substances involved in a wound healing process (e.g. growth factors, stem cells, and extracellular matrix), effective and safe wound therapeutics are still limited. There is an unmet need to develop new therapeutics. Various new pathways and targets have been identified and could become a molecular target in designing novel wound agents. Importantly, many existing drugs that target these newly identified pathways could be repositioned for wound therapy, which will facilitate fast translation of research findings to clinical applications. This review discusses the newly identified pathways/targets and their potential uses in the development of wound therapeutics. Some herbs and amphibian skins have been traditionally used for wound repairs and their active ingredients have been found to act in these new pathways. Hence, screening these natural products for novel wound therapeutics remains a viable approach. The outcomes of wound care using natural wound therapeutics could be improved if we can better understand their cellular and molecular mechanisms and fabricate them in appropriate formulations, such as using novel wound dressings and nano-engineered materials. Therefore, we also provide an update on the advances in the wound therapeutics from natural sources. Overall, this review offers new insights into novel wound therapeutics.

scholarly journals Prevention and therapy of acute and chronic wounds using NPWT devices during the COVID-19 pandemic, recommendation from The NPWT Working Group

2020 ◽  
Vol 7 (2) ◽  
Author(s):  
Tomasz Banasiewicz ◽  
Rolf Becker ◽  
Adam Bobkiewicz ◽  
Marco Fraccalvieri ◽  
Wojciech Francuzik ◽  
...  
Keyword(s):  
Wound Healing ◽  
Chronic Wounds ◽  
Hospital Admissions ◽  
Wound Care ◽  
Care Center ◽  
Management Strategies ◽  
Hospital Staff ◽  
Wound Management ◽  
Health Care Center ◽  
Single Use

Recent SARS-CoV-2 pandemic leading to a rapidly increasing number of hospitalizations enforced reevaluation of wound management strategies. The optimal treatment strategy for patients with chronic wounds and those recovering from emergency and urgent oncological surgery should aim to minimize the number of hospital admissions, as well as the number of surgical procedures and decrease the length of stay to disburden the hospital staff and to minimize viral infection risk. One of the potential solutions that could help to achieve these goals may be the extensive and early use of NPWT devices in the prevention of wound healing complications. Single-use NPWT devices are helpful in outpatient wound treatment and SSI prevention (ciNPWT) allowing to minimize in-person visits to the health care center while still providing the best possible wound-care. Stationary NPWT should be used in deep SSI and perioperative wound healing disorders as soon as possible. Patient’s education and telemedical support with visual wound healing monitoring and video conversations have the potential to minimize the number of unnecessary in-person visits in patients with wounds and therefore substantially increase the level of care.

Wound infections: an overview

2021 ◽  
Vol 26 (Sup6) ◽  
pp. S22-S25
Author(s):  
Martha Williams
Keyword(s):  
Wound Infection ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Economic Factors ◽  
Ageing Population ◽  
Wound Infections ◽  
The Many ◽  
Systemic Therapies ◽  
Socio Economic Factors

In the ever-changing world of wound care and nursing, it remains apparent that chronic wounds are a growing challenge. Evidence shows that age increases the likelihood of developing a chronic wound, which supports the notion that the burden of these wounds on the NHS is likely to further intensify with the ageing population. There are many reasons why a wound may fail to progress, including wound aetiology, comorbidities and environmental and socio-economic factors. One of the most significant reasons why wounds may fail to progress and become chronic is untreated wound infection. In order for clinicians to be able to treat and manage wound infections, it is vital that they understand how infection develops, the many ways in which infections may present themselves and how and when to initiate appropriate topical and systemic therapies to treat wound bed infections. The present article provides an overview of wound bed infections and their management.

Evidence for person-centred care in chronic wound care: A systematic review and recommendations for practice

2020 ◽  
Vol 29 (Sup9b) ◽  
pp. S1-S22 ◽  
Author(s):  
Georgina Gethin ◽  
Sebastian Probst ◽  
Jan Stryja ◽  
Natalia Christiansen ◽  
Patricia Price
Keyword(s):  
Systematic Review ◽  
Wound Healing ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Patient Knowledge ◽  
Person Centered Care ◽  
Centered Care ◽  
Recommendations For Practice ◽  
The Impact

Background Chronic wounds affect an estimated 2.21 per 1000 population. They are a significant source of morbidity and affect individuals physically, psychologically, socially and financially. Person-centered care is one approach to improve patient outcomes in wound care as it values patients' perspectives, beliefs and autonomy and considers the person as a whole within the cultural context in which care is provided. Aim We aimed to review the evidence on the use of person-centered care (PCC) in chronic wound care management and provide recommendations for practice and future research. Method Using a systematic review methodology, we searched six databases for full-text papers from 2009–2019 published in peer-reviewed journals with no limits on language. Results Eighteen articles on studies involving 3149 patients from nine countries were identified. Studies were conducted under three broad intervention categories: healthcare professional education (n=1); patient education (n=14) and telemedicine (n=3). Studies were equally focused on prevention and treatment of chronic wounds. Significant improvements were reported in patient knowledge, pain and self-care behaviours. Only two studies evaluated the impact on wound healing and one study estimated the cost of implementing person-centered care. Conclusions The evidence base to support PCC in wound management is developing and based on our review has shown improved outcomes in areas of pressure ulcer prevention, patient satisfaction, patient knowledge and quality of life, but clinical outcomes such as wound healing were less well explored. Further research with more objective outcome measures are required.

Varicose vein surgery in elderly patients: What needs to be considered?

Phlebologie ◽  
2017 ◽  
Vol 46 (04) ◽  
pp. 221-223
Author(s):  
A. Mumme ◽  
M. Dünnweber
Keyword(s):  
Varicose Vein ◽  
Geriatric Patients ◽  
Varicose Veins ◽  
Surgical Techniques ◽  
Anaesthetic Techniques ◽  
The Elderly ◽  
Laryngeal Tube ◽  
Ageing Population ◽  
Varicose Vein Surgery ◽  
Operative Trauma

SummaryThe need for invasive therapeutic measures in patients with varicose veins increases in an ageing population. Modern varicose vein surgery is particularly suitable for this age group, precisely because the stage of the disease is often advanced in geriatric patients. Gentle surgical techniques, such as invaginated stripping, cause the least possible operative trauma and are therefore especially suitable for the aged body. Less stressful anaesthetic techniques, such as tumescence, spinal anaesthesia or total intravenous anaesthesia with the use of a laryngeal tube, are likewise particularly well-suited for the treatment of geriatric patients with varicose veins.Special criteria regarding the ASA classification and anticoagulation must be applied when considering the perioperative risk in frequently multimorbid geriatric patients. Very few complications generally occur in patients at ASA stages 1 and 2 and under single anticoagulant therapy, and surgery is feasible even in elderly people. In the case of existing phenprocoumon treatment, bridging should be critically considered on a case-by-case basis. Perioperative prevention and management of hypothermia and special procedures to obtain postoperative convalescence should also be adapted to the particular needs of the elderly patient.

Role of Nitric Oxide in Wound Healing

2002 ◽  
Vol 4 (1) ◽  
pp. 5-15 ◽  
Author(s):  
Beverly B. Childress ◽  
Joyce K. Stechmiller
Keyword(s):  
Nitric Oxide ◽  
Wound Healing ◽  
Growth Factors ◽  
Animal Studies ◽  
Chronic Wounds ◽  
Current Knowledge ◽  
Wound Care ◽  
Impaired Wound Healing ◽  
Normal Wound Healing ◽  
Age Related

Chronic wounds mainly affect elderly individuals and persons with comorbid diseases due to a compromised immune status. An age-related decline in immune function deters proper healing of wounds in an orderly and timely manner. Thus, older adults with 1 or more concomitant illnesses are more likely to experience and suffer from a nonhealing wound, which may drastically decrease their quality of life and financial resources. Novel therapies in wound care management rely heavily on our current knowledge of wound healing physiology. It is well established that normal wound healing occurs sequentially and is strictly regulated by pro-inflammatory cytokines and growth factors. A multitude of commercial products such as growth factors are available; however, their effectiveness in healing chronic wounds has yet to be proven. Recently, investigators have implicated nitric oxide (NO) in the exertion of regulatory forces on various cellular activities of the inflammatory and proliferative phases of wound healing. Gene therapy in animal studies has shown promising results and is furthering our understanding of impaired wound healing. The purpose of this article is to review the literature on NO and its role in wound healing. A discussion of the physiology of normal healing and the pathophysiology of chronic wounds is provided.

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