Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
First Faculty of Medicine, Charles University, Prague, Czech Republic.
Drugs Aging. 2022 Aug;39(8):619-629. doi: 10.1007/s40266-022-00963-w. Epub 2022 Jul 13.
Older people often suffer from different types of ulcers, with the most prevalent being chronic leg ulcers (CLUs) and diabetic foot ulcers. There are major issues in the current medical approach because these ulcers are hard to heal, and, in the case of CLUs, very painful and with a high frequency of relapse. Older people complain of pain more frequently than young people, frequently due to a combination of painful chronic wounds with other comorbidities (e.g. arthritis, peripheral arterial disease, vertebrogenic pain syndrome). However, chronic pain appears to be managed better by older people because the pain sensitivity is downregulated and the pain threshold is higher in older people. Pain management of chronic wounds is often insufficient, especially in older individuals. It is highly important to use non-traumatic wound dressings and pay attention to patients' feelings and fears because pain in chronic ulcers can impair wound healing. Key factors include good preparation for dressing change and adequate analgesia, ideally a combination of topical and oral agents.
老年人常患有不同类型的溃疡，其中最常见的是慢性腿部溃疡（CLUs）和糖尿病足溃疡。目前的医疗方法存在重大问题，因为这些溃疡难以愈合，而且在 CLUs 的情况下非常疼痛，且复发频率很高。老年人比年轻人更频繁地抱怨疼痛，这通常是由于疼痛性慢性伤口与其他合并症（如关节炎、外周动脉疾病、脊椎源性疼痛综合征）的组合所致。然而，老年人似乎更好地管理慢性疼痛，因为老年人的疼痛敏感性下调，疼痛阈值更高。慢性伤口的疼痛管理往往不足，尤其是在老年人中。使用非创伤性伤口敷料并关注患者的感受和恐惧非常重要，因为慢性溃疡中的疼痛会损害伤口愈合。关键因素包括为敷料更换做好充分准备和提供足够的镇痛，理想情况下是局部和口服药物的联合使用。
