Gould Lisa, Abadir Peter, Brem Harold, Carter Marissa, Conner-Kerr Teresa, Davidson Jeff, DiPietro Luisa, Falanga Vincent, Fife Caroline, Gardner Sue, Grice Elizabeth, Harmon John, Hazzard William R, High Kevin P, Houghton Pamela, Jacobson Nasreen, Kirsner Robert S, Kovacs Elizabeth J, Margolis David, McFarland Horne Frances, Reed May J, Sullivan Dennis H, Thom Stephen, Tomic-Canic Marjana, Walston Jeremy, Whitney Jo Anne, Williams John, Zieman Susan, Schmader Kenneth
Wound Recovery and Hyperbaric Medicine Center, Kent Hospital, Warwick, Rhode Island.
J Am Geriatr Soc. 2015 Mar;63(3):427-38. doi: 10.1111/jgs.13332. Epub 2015 Mar 6.
Older adults are more likely to have chronic wounds than younger people, and the effect of chronic wounds on quality of life is particularly profound in this population. Wound healing slows with age, but the basic biology underlying chronic wounds and the influence of age-associated changes on wound healing are poorly understood. Most studies have used in vitro approaches and various animal models, but observed changes translate poorly to human healing conditions. The effect of age and accompanying multimorbidity on the effectiveness of existing and emerging treatment approaches for chronic wounds is also unknown, and older adults tend to be excluded from randomized clinical trials. Poorly defined outcomes and variables; lack of standardization in data collection; and variations in the definition, measurement, and treatment of wounds also hamper clinical studies. The Association of Specialty Professors, in conjunction with the National Institute on Aging and the Wound Healing Society, held a workshop, summarized in this article, to explore the current state of knowledge and research challenges, engage investigators across disciplines, and identify research questions to guide future study of age-associated changes in chronic wound healing.
与年轻人相比,老年人更易患慢性伤口,且慢性伤口对这一人群生活质量的影响尤为显著。伤口愈合会随着年龄增长而减缓,但慢性伤口的基础生物学机制以及与年龄相关的变化对伤口愈合的影响却鲜为人知。大多数研究采用体外方法和各种动物模型,但观察到的变化很难转化为人类的愈合情况。年龄及伴随的多种疾病对现有和新兴慢性伤口治疗方法有效性的影响也尚不清楚,而且老年人往往被排除在随机临床试验之外。结果和变量定义不明确;数据收集缺乏标准化;伤口定义、测量和治疗的差异也阻碍了临床研究。专业教授协会与美国国立衰老研究所及伤口愈合协会联合举办了一次研讨会(本文对此进行了总结),以探讨当前的知识现状和研究挑战,促使跨学科研究人员参与,并确定研究问题,以指导未来对慢性伤口愈合中与年龄相关变化的研究。