Preventive tips for those at higher risk for chronic wounds

January 6, 2016

According to the latest U.S. Census figures, there are now more Americans age 65 and older than at any other time in U.S. history and that number is expected to increase more rapidly over the next decade as more baby boomers turn 65.

"According to the National Institutes of Health, aging skin repairs itself at a slower pace than younger skin with wound healing sometimes as much as four times slower in the elderly," said Scott Covington, MD, FACS, CHWS, Executive Vice President, Medical Affairs for Healogics, a network comprised of academic medical centers, hospitals and professionals committed to advancing wound healing by creating, sharing, and activating wound prevention and care expertise. "In addition to the normal aging process, other factors such as underlying medical conditions, increased falls and poor nutrition play a role."

As a normal part of aging, the outer skin layer thins and blood vessels become more fragile leading to bruising and bleeding under the skin.  The fat layer under the skin also becomes thinner reducing its normal padding which can protect against injury.

While no one can turn back the clock, Dr. Jim White, medical director for SageWest’s Center for Wound Care and Hyperbaric Medicine, offers the following tips to reduce and prevent the risk of chronic wounds for those over 65:

Pay attention to your overall health: People with chronic wounds often have other underlying conditions such as diabetes, peripheral arterial disease, vascular disease or radiation injuries.  As people get older, they are more likely to develop one or more of these conditions and managing them properly helps the body heal wounds faster.

Be on the lookout: Physical changes in the skin as we age can reduce our ability to sense touch and pressure. In addition, conditions such as diabetes may cause nerve damage which can impair sensation of feeling and failing eyesight can make it difficult to detect changes in the skin.  Inspect your skin and feet for reddened skin that gets worse over time, blisters or open sores.  If you have trouble seeing, ask a family member or caregiver to help you.

Know your medications: A study of U.S. emergency rooms found that the incidence of adverse drug events increased continuously for patients over 60.  Often antibiotics or other medications will be needed to treat wounds against infection.  It is important for your medical providers to have a list of what medicines you are currently taking and any to which you are allergic.

Watch your balance: According to the Centers for Disease Control and Prevention, more than one-third of adults ages 65 years and older fall each year.  Balance disorders may be caused by aging, problems with the inner ear, medications, infections, poor blood circulation or other conditions.  See your doctor to diagnose the cause and take extra care when standing, sitting and walking.

Eat properly:  Nutritional deficiencies can lead to skin changes such as rashes and not drinking enough water also increases the risk of skin injury.

Take care of your skin: Sebaceous glands under the skin produce less oil as you age resulting in dry and sometimes itchy skin.  Use lotions and moisturizers to keep skin moist and more ready to heal. 

Guard against pressure ulcers: More commonly known as bed sores, pressure ulcers occur when an area of skin under constant pressure breaks down.  Risk factors include being older, having limited mobility, having a condition that inhibits blood flow and malnourishment.  Pressure ulcers typically form on skin close to bones such as in areas around the elbows, heels, hips, ankles, shoulders, back and back of the head. Do not massage the area around a pressure ulcer since it can tear the skin and break fragile blood vessels. See your health care provider for instructions on how to care for the wound and for preventive measures such as the proper kind of pillows and cushions that may alleviate pressure.

Know when to seek medical treatment: Infections can delay healing and spread to other parts of the body.  Warning signs include increased pain at the wound site, redness or swelling spreading away from the wound, a foul wound odor, change in color or amount of drainage from the wound or if you experience fever, chills, nausea or vomiting.