complex co-morbidities: a case report
Aging is associated with an increased likelihood of co-morbidity and other factors that are known to delay wound healing (Gosain and DiPetro, 2004; Bonifant and Holloway, 2019). Additionally, aging itself is a risk factor for chronicity as a consequence of changes in the epidermis and dermis. The dermo-epidermal junction becomes flattened, and elasticity of the skin reduces due to morphological changes in collagen and elastin, which predispose the tissue to shear and friction forces (Gosain and DiPetro, 2004; Bonifant and Holloway, 2019). Moreover, the microcirculation and lymphatic drainage of the dermis is decreased with age, and this affects its ability to adapt to injury and clear the wound of pathogens thus inhibiting wound contraction (Gosain and DiPetro, 2004). Older patients, frequently described in the literature as aged 65 years or above, often have multiple comorbidities, such as poor circulation, poor nutritional and hydration status, and the presence of diseases such as diabetes that affect general health (Leung et al, 2018; Wilkinson and Hardman, 2020). These comorbidities can negatively influence the wound healing trajectory, making vigilance during wound management … read more