How Aging Affects Wound Healing

In older patients, the skin changes associated with aging lead to prolonged wound healing time. Although delayed healing is partially due to physiologic changes, it is usually complicated by other problems associated with aging, such as poor nutrition and hydration, the presence of a chronic condition, or the use of multiple medication.

Practitioners should be aware of the following factors that impede healing in older patients:

* slower turnover rate in epidermal cells

* poorer oxygenation at the wound due to increasingly fragile capillaries and a reduction in skin vascularization

* altered nutrition and fluid intake resulting from physical changes that can accompany aging, such as reduced saliva production, a declining sense of smell and taste, or decreased stomach motility

* altered nutrition and fluid intake attributable to troubling personal or social issues, such as loose-fitting dentures, financial concerns, eating alone after the death of a spouse, or problems preparing or obtaining food

* impaired function of the respiratory or immune systems

* reduced dermal and subcutaneous mass leading to an increased risk of chronic pressure ulcers

* lack of tensile strength in a healed wound, putting the skin at risk for reinjury.

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