Wound care in the geriatric client

Review

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Authors: Steve Gist, Iris Tio-Matos, Sharon Falzgraf, Shirley Cameron, Michael Beebe

Published Date June 2009 Volume 2009:4 Pages 269 - 287

DOI: http://dx.doi.org/10.2147/CIA.S4726

Steve Gist, Iris Tio-Matos, Sharon Falzgraf, Shirley Cameron, Michael Beebe

Geriatrics and Extended Care, Programs, VA Puget Sound Health Care Systems, American Lake Division, Tacoma, WA, USA

Abstract: With our aging population, chronic diseases that compromise skin integrity such as diabetes, peripheral vascular disease (venous hypertension, arterial insufficiency) are becoming increasingly common. Skin breakdown with ulcer and chronic wound formation is a frequent consequence of these diseases. Types of ulcers include pressure ulcers, vascular ulcers (arterial and venous hypertension), and neuropathic ulcers. Treatment of these ulcers involves recognizing the four stages of healing: coagulation, inflammation, proliferation, and maturation. Chronic wounds are frequently stalled in the inflammatory stage. Moving past the inflammation stage requires considering the bacterial burden, necrotic tissue, and moisture balance of the wound being treated. Bacterial overgrowth or infection needs to be treated with topical or systemic agents. In most cases, necrotic tissue needs to be debrided and moisture balance needs to be addressed by wetting dry tissue and drying wet tissue. Special dressings have been developed to accomplish these tasks. They include films, hydrocolloids, hydrogel dressings, foams, hydro-fibers, composite and alginate dressings.

Keywords: wound care, pressure ulcers, vascular ulcers, diabetic ulcers, debridement, elderly