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老年重度烧伤患者的伤口愈合:临床治疗考量与挑战

Wound healing in older adults with severe burns: Clinical treatment considerations and challenges.

作者信息

Romanowski Kathleen S, Sen Soman

机构信息

Department of Surgery, University of California, Davis, 2335 Stockton Blvd., Sacramento, CA 95817, USA.

Shriners Hospitals for Children - Northern California, 2425 Stockton Blvd., Sacramento, CA 95817, USA.

出版信息

Burns Open. 2022 Apr;6(2):57-64. doi: 10.1016/j.burnso.2022.01.002. Epub 2022 Feb 1.

Abstract

BACKGROUND

The older adult population continues to rapidly expand in number, with a projection by the United States (US) Census Bureau that there will be more individuals older than > 65 years (77.0 million) than those younger than < 18 years (76.5 million) by 2034. This review provides an overview of aging as it relates to wound healing and burn injuries in older adult patients, summarizes current treatment practices, and addresses the key challenges and considerations for treating severe burn injuries in this specific patient population.

MATERIALS AND METHODS

A narrative literature search was conducted, focusing on recent primary literature on burns and wound healing in elderly patients.

RESULTS

Studies showed that the aging process results in both physiologic (eg, nutritional and metabolic status) and anatomic changes (eg, thinning dermis) that contribute to a reduced capacity to recover from burn-injury trauma compared with younger patients. Owing to impaired vision, decreased coordination, comorbidities, and medication-induced side effects, older adults (ie, > 65 years) are susceptible to severe burn injury (deep-partial thickness and full-thickness), which is associated with significant morbidity and mortality.

CONCLUSION

A better understanding of the effects of age-related changes regarding wound healing in older adult patients who incur severe burn injuries may provide insight into clinical strategies to improve outcomes among this population.

摘要

背景

老年人口数量持续快速增长,美国人口普查局预测,到2034年,65岁以上的老年人(7700万)将超过18岁以下的青少年(7650万)。本综述概述了衰老与老年患者伤口愈合和烧伤的关系,总结了当前的治疗方法,并探讨了治疗该特定患者群体严重烧伤的关键挑战和注意事项。

材料与方法

进行了一项叙述性文献检索,重点关注近期关于老年患者烧伤和伤口愈合的原始文献。

结果

研究表明,与年轻患者相比,衰老过程会导致生理(如营养和代谢状况)和解剖学变化(如真皮变薄),从而降低从烧伤创伤中恢复的能力。由于视力受损、协调性下降、合并症和药物引起的副作用,老年人(即65岁以上)易受严重烧伤(深二度和三度)的影响,这与高发病率和死亡率相关。

结论

更好地了解严重烧伤的老年患者中与年龄相关的变化对伤口愈合的影响,可能有助于深入了解改善该人群治疗效果的临床策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ea8/9104500/8f5cca908fc5/nihms-1803141-f0001.jpg

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