The Importance of Wound Management in the Elderly

With a growing ageing population and increase in chronic diseases, chronic wounds are becoming more frequent. Often occurring in the elderly, chronic wounds are defined as wounds that take more than four to six weeks to heal.

Pressure ulcers, which lead to chronic wounds, can cause high degrees of pain, discomfort and decreased mobility. Older people with these types of wounds also suffer from higher death rates. Chronic wounds are a very serious and potentially life-threatening issue, so it is vital that carers and aged care facilities be knowledgeable in how to combat such traumas.

Wound Care in Australia

Research has shown that 17-35% of individuals have pressure ulcers on admission to aged care facilities and observation of prevalence range from less than 5% to up to 26%. A separate study showed that 57% of referrals to a home-care nursing service were for wound care. Though mostly prevalent in the elderly, up to 2% of Australia’s population live with recurrent ulcers of the leg.

Financially, a stage 4 pressure ulcers can cost a patient in excess of $60 000 to manage. It has been estimated that pressure ulcers cost approximately $286M a year in hospital beds.

Cause

Elderly people with neurological impairments and those who are immobile for extended periods of time are at a high risk of developing pressure ulcers. Other risk factors include arthritis, chronic liver disease, diabetes inflammatory disease, cognitive dysfunction, renal failure, vascular disease and weakened immune system. Lower limb amputation, which can be the result of diabetes, can also result in an infected ulcer. Half of all amputations occur in people with diabetes. Generally, anyone over the age of 65 with poor nutrition and poor circulation can be at risk of developing pressure ulcers.

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Research to Aid Wound Healing

Chronic wounds require professional attention, and usually the support of a management team that can, but not exclusively, include physicians, specialist wound care nurses, dieticians, physiotherapists, community/home-care nurses or other carers. However, there are also some simple methods that research has shown aids in the healing process.

Nutrition

Nutrition is a vital part of wound healing and wound care practices. Poor nutrition can slow down and even impair the quality of the wound healing process.  The nutritional factors that contribute to wound healing include proteins, fats, carbohydrates, antioxidants like Vitamin C, Vitamin A and Vitamin E and minerals such as Zinc and Iron. Not only does poor nutrition result in poor healing, but a poorly healing wound can also result in a loss of nutrition through the wound. Thus, good nutrition is essential to wound healing and overall recovery.

Supplements

To aid in wound healing, particularly when the patient has poor nutrition, supplements can be taken to speed up the process. Nestle Nutrition has created Arginaid® (Nestlé Health Science) is a nutritional supplement to aid in speeding up the wound healing process a supplement specifically designed to aid in wound management. The key ingredient in Arginaid is L-Arginine, an amino acid that takes part in structural protein synthesis and is required in additional amounts when the body is under stress (e.g. wound healing). Research has shown that dietary supplements with arginine help enhance protein metabolism, helping decrease muscle loss and collagen synthesis.

There are other treatment options to consider to help aid healing, to learn more consult your GP.

A personal story of the types of wounds Arginaid® can treat

Mrs. Jones* is a 91-year-old woman with a history of dementia. She has been bed-bound for the past two years and is cared for at home. Mrs. Jones was admitted to hospital with a stage 3 sacral pressure ulcer that was approximately the size of a fifty cent coin. Mrs. Jones has very low energy and low protein intake which slowed down and impaired the wound healing process. Though her weight is within healthy range for her age, doctors checked her blood work and saw that she had several imbalances.

To treat Mrs. Jones’ wound, a specific bandaging was used and changed every two to three days. This was part of a “pressure management” plan which included a special air mattress prescribed specifically for people with pressure sores and as well as a turning schedule since she was completely bed-ridden. To aid in the healing process, Mrs. Jones was given two Arginaid® Extra per day for two weeks.

Two weeks after the addition of Arginaid® Extra to Mrs. Jones’ diet, the wound’s surface area decreased to about the size of a one dollar coin, 66% of its original size. Healing continued at this rate until the sixth week when the wound surface area had decreased to just slightly smaller than a five cent coin, 33% of its original size. Over the following five weeks the wound surface area decreased to 29% of its original size.

If you know someone with a chronic wound (Stage 2 or above) that’s not healing then ask your GP about other treatment options or Arginaid® supplements today.

This post is sponsored by Nestlé Health Science. At HelloCare we only published articles that we believe delivers valuable health insights into a subject important to HelloCare’s community. For more information about Arginaid®, please call 1800 552 580 (VPAC) or 1800 671 628

Arginaid® is now available on the Repatriation Schedule of Pharmaceutical Benefits (RPBS) for eligible Veterans (Gold, White and Orange card holders) with a Stage 2 pressure injury. Consult your doctor today.

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  1. My 85yo father with advanced heart failure and chronic kidney disease, has very fragile skin, and usually has numerous small skin wounds which take ages to heal because of poor oxygen supply to the tissues. He also gets very swollen legs which weep and sometimes rapidly drip fluid (weeping edema they call it).
    I always take care to clean and cover these wounds, but when he goes to hospital they say it is better to let them breathe. I say that once the skin has covered I think they is ok, but while there is blood oozing I think they need to be covered. Some nurses refuse.
    Twice he has had been diagnosed with bacterial cellulitis and sepsis (acinetobacter baumanii and klepsiella), the first arising in the hospital, the second in a nursing home when I was having a short break from caring. The microbiology guy said “The question is – how did it get in his blood?” I said maybe through his wounds? If they are bleeding and uncovered it will be easier for the bacteria to get in perhaps? No response.
    The nurses continue to leave his wounds uncovered saying its better for them to air.
    What are people’s thoughts on this please?

    1. It sounds like your father needs to see a wound specialist and/or a dietician to ensure he is also getting the nutrition needed to assist in repairing the wound.

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