Why wounds take longer to heal as we age

Minor abrasions that once would have healed quickly can bleed under the skin with older age. — dpa

A bump against the corner of a table or a scratch while peeling an apple – small wounds like these are quickly forgotten in our younger years, but not so for older skin.

Sooner or later, everyone must prepare to have skin that heals more slowly.

Older people’s wounds take longer to heal, and sometimes, may not heal at all.

So there are a few things everyone should bear in mind, as this is an area where special care is needed sooner or later, according to Dr Steffen Schirmer of a German wound treatment association.

The main difference for older people is that their cells and metabolic processes are slower, meaning that any damaged cells don’t regenerate as well, so their wounds are slower to heal, he says.

Cell connections aren’t as strong and the connective tissue loses elasticity.

The skin is no longer as robust when under pressure or friction, which manifests visibly as wrinkles.

It is much more susceptible to injuries or infections.

If the older person has a weak heart, then that disturbs their blood circulation and can lead to a swelling of the legs.

Skin can crack, and these cracks can become infected if exposed to bacteria.

Meanwhile, older people have had more exposure to the sun’s harmful ultraviolet (UV) rays, which also further damages the skin.

Additional complications can occur when older people take anti-coagulants, which help prevent blood clots.

However, this can also mean that any minor injuries caused by bumps or scratches may bleed for a long time.

In some cases, they bleed under the skin, creating darker spots that can also lead to wounds.

Dr Schirmer, who is also head physician of Sankt Marien Hospital’s plastic surgery department in Berlin, answers a few commonly- asked questions about wounds:

What’s the best way to treat wounds?

It’s best to cover a fresh wound with a sterile compress or a plaster.

You should clean it with a saline solution or antiseptics.

If the bleeding doesn’t stop, go to the emergency room as they can stop the bleeding and suture it if needs be.

Sometimes however, it’s enough to put on a plaster at home and let it heal by itself.

But do watch the wound – if it becomes red and warm to the touch, that could be a bacterial infection.

Go to the doctor if that’s the case.

Which doctor is best to see if you have a wound?

Your family doctor is the first port of call, no matter what.

As you age, however, you need to be more aware.

The doctor might prescribe an expensive wound dressing, but you’ll also need to make sure that you get the appropriate aftercare to ensure that everything heals well.

If, after eight weeks, a wound still hasn’t healed, then it is considered to be chronic, so the doctor will have to take a closer look to see if it could be caused by undetected diabetes or a circulatory disorder.

Chronic wounds occur mainly in people who have a chronic disease.

Skin cancer could be another possible cause if a wound won’t heal.

Is it possible for someone who is chronically ill to prevent chronic wounds?

The most serious chronic wounds occur on the feet of many diabetics on the one hand, while on the other, bedridden patients can get pressure ulcers.

It is always important to take a close look at the skin in order to prevent these.

You want to watch to see whether there are changes, or areas that are red after prolonged walking, standing or sitting.

Often, these are areas of skin that are under maximum stress and also have poorer blood supply.

Diabetologists can also use pressure measurements to identify such areas that then need to be relieved, e.g. with special shoes or soles that cushion vulnerable areas, or even relieve the pressure completely.

Using skin care creams is also important, especially for diabetics, to prevent the skin from drying out, particularly on the feet.

You can also get professional care from a podiatrist, as with diabetic foot syndrome, the nerves are damaged, and the sebaceous and sweat glands become inoperable, so that the person no longer perceives pain.

What is generally the best way to help wounds heal in old people?

Exercise and a healthy cardiovascular system always help.

A balanced diet is important too.

Many elderly people are undernourished, eating too little protein, which they need for their cells to regenerate.

When people have a chronic wounds, they also lose protein through the wound fluid.

People with open wounds also use more calories and energy that they need to replace.

One way to do so is through protein-rich drinks, for example, if the older person’s appetite is sluggish. – By Christina Bachmann/dpa