Wound in Geriatrics
WOUNDS IN GERIATRICS
As we age our skin becomes, thinner, drier and more fragile and sensitive to our surroundings, be it heat, friction, cleaning agents or the environment in general. Also, chronic conditions like Diabetes, stroke, etc lead to a higher risk of slow healing wounds and ulcers. A multidisciplinary approach to manage chronic illness, hygiene, physiotherapy, change of position, nutrition, debridement and dressings etc are required these.
Common wounds in Geriatrics:
- Pressure ulcers also known as bed sores caused due to continuous pressure on bony prominences common in older persons with immobility
- Vascular ulcers: these may be due to incompetence in the veins and arteries impacting blood circulation especially in the lower limb.
- Neuropathic ulcers: These are common in older adults with Diabetes in which nerve damage and are insensitive to pain and injuries.
- Atypical wounds: These may indicate an underlying issue like skin malignancy.
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Contributing factors:
- Aging skin
- Chronic diseases
- Immobility
- Poor nutrition
- Medications
Management and treatment:
- Prevention: Prevention is the key. Timely change of position, special mattresses, physiotherapy and good nutrition.
- Assessment: Assessment of the wound to manage it well and to manage its underlying cause.
- Debridement: Removal of dead tissue to stimulate new granulation and wound healing.
- Moisture balance: choice of dressings depending on the type of wound to facilitate faster healing.
- Systemic antibiotics: timely medications to treat infections as older adults may have difficulty clearing infections.
Control and management of venous insufficiencies like limb elevation, bandaging to relieve swelling and promote fluid clearance. The best outcomes are when there is a proper sync with the health care team attending the senior.
