Why does a small cut on an elderly person’s leg take months to heal?
At age 25, a cut heals in about a week. At age 75, that same cut can take… months. Sometimes even longer. And it’s not just frustrating. Chronic wounds in the elderly can cause:
- Infections
- Hospital stays
- Lost independence
Here’s the scary part:
In America, chronic wounds are experienced by one in six Medicare beneficiaries. This equals approximately 10.5 million individuals living with a wound that will not heal.
The good news?
Why wounds heal slower as you age is actually pretty clear cut. There are also lots of easy (and some not-so-easy) ways to speed up the process.
Time to dive in…
Here’s what’s inside:
- Why Do Wounds Heal Slower With Age?
- The Oxygen Problem (and a Pressurized Fix)
- The Biggest Healing Blockers In Older Adults
- 5 Simple Ways To Help Wounds Heal Faster
Why Do Wounds Heal Slower with Age?
Healing occurs by collaboration within the body. The blood delivers oxygen and nutrients. White blood cells remove bacteria. Finally, skin cells regenerate over the missing area.
When you’re young, this team works fast. As time passes… each individual player slows down.
Skin becomes thinner and dryer. Blood vessels become less flexible meaning less blood flows to the wound. And your immune system doesn’t respond as rapidly as before.
Think of it like this:
A wound is a construction zone. Oxygen is the fuel delivery truck. If it arrives late (or half-empty) the workers stand around idle.
That’s exactly what happens in older skin.
The Oxygen Problem (and a Pressurized Fix)
Wounds require oxygen to heal properly. If not provided with sufficient oxygen, new tissue will develop slowly and bacteria can move in much more easily.
This is why many wound clinics are using hyperbaric oxygen therapy (HBOT) these days. The patient sits or reclines in a sealed chamber as the pressure increases. With increased pressure, the blood can transport significantly more oxygen to hypoxic tissue.
Hard shell hyperbaric chambers are constructed out of hard materials like steel or acrylic. This allows the chamber to withstand greater pressure than soft, inflatable chambers. A 2.0 ATA hyperbaric chamber provides twice the amount of normal air pressure. That level falls within the 2-3x pressure range used for most wound healing studies. Increased pressure is what allows oxygen to penetrate further into chronically damaged tissue.
Does science back it up?
Essentially yes. A meta-analysis of randomized trials concluded that patients with diabetic foot ulcers were 3.5x more likely to heal completely when HBOT was used as an adjunct to standard care.
HBOT should be used in conjunction with proper wound care, not as a substitute for it. If you have lung, ear or heart disease, consult your physician prior to use.
The Biggest Healing Blockers in Older Adults
Age isn’t the only villain either. There is usually a “sidekick” sabotaging the healing process of most chronic wounds.
Diabetes
Elevated blood sugar injures nerves and small blood vessels, particularly in the feet. A blister can become an ulcer and the person may not even feel it.
Poor Circulation
Venous or arterial ulceration caused by incompetent veins or arteries is extremely prevalent in the elderly population. If blood flow is impaired, the wound does not receive the nourishment it needs.
Pressure
Remaining seated or lying down for extended periods of time compresses skin over bony prominences such as the hips and heels. This pressure restricts blood flow and results in pressure ulcers.
Poor Nutrition
This one is probably overlooked more than any other. Skin needs protein, vitamins and hydration to heal itself. Many times as people age… they eat less and their wounds suffer.
Medications
Certain medications such as steroids can delay healing. Never discontinue medication without consulting your doctor!
Here’s the thing:
The majority of older adults deal with several of these at once. This is why an injury that “should” take 3 weeks ends up taking months to heal.
5 Simple Ways to Help Wounds Heal Faster
Okay, now for the good stuff. These are fundamentals that every wound care team addresses daily. They’re not hard…but they are best done as a team.
1. Keep The Wound Clean And Covered
The old advice was to “allow air exposure.” No longer. Most wounds heal faster if they are kept clean, moist (but not too wet) and covered with an appropriate dressing. Change dressings as recommended and wash your hands each time.
2. Feed The Healing Process
Protein helps make new skin. Eggs, fish, beans, chicken and yoghurt are all simple sources. Make sure you drink lots of water as well. Older adults sometimes heal faster with a protein supplement. It doesn’t hurt to ask your doctor or dietitian.
3. Get Moving (And Take The Pressure Off)
Movement increases circulation. Short walks around the house are beneficial. If someone is bedridden most of the day, shift their position frequently. Cushion vulnerable pressure points. There are special cushions and mattresses designed for this.
4. Control Blood Sugar
If you have diabetes, this is huge. Consistent blood sugar equals good circulation and a healthy immune system. Inspect your feet daily for cuts, blisters or color changes. Addressing an issue early can make a huge difference.
5. Watch for Warning Signs
Know when to call a doctor. The red flags to look out for are:
- Spreading redness or warmth
- Pus or a bad smell
- Fever
- No improvement after 2x weeks
Don’t wait it out. Infections in older adults can get serious fast.
Bringing It All Together
Slow healing wounds affect many elderly people, but they don’t have to be a life sentence. Your skin ages, circulation gets worse, diabetes sets in and your diet may contribute. Correct as many of those variables as you can and healing will happen quicker.
To quickly recap:
- Keep wounds clean, moist and covered
- Eat enough protein and drink water
- Move often and take the pressure off
- Keep blood sugar steady
- Ask about extra options like HBOT for stubborn wounds
Easy peasy. Keep it simple. Partner with your wound care team… and allow the body every opportunity to heal.
Frequently Asked Questions
What is a hard shell hyperbaric chamber?
A hard shell hyperbaric chamber is a rigid chamber which encloses an area that can be sealed off from the outside air for oxygen delivery. The lack of flexing walls allows for higher chamber pressures compared to soft chambers. The increased pressure affects how wounds heal.
How long does a wound take to heal in older adults?
It depends on the wound and overall health of the individual. Minor abrasions can take weeks. Diabetic or circulation related ulcers can take months if not cared for properly.
When is a wound considered chronic?
Doctors usually define a wound as chronic if it has not shown significant improvement within 4-6 weeks.