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Pressure Injury and Chronic Wounds

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Geriatric Medicine

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Abstract

Chronic wounds in older persons include a spectrum of pathologies and generally occur with a backdrop of multiple comorbidities rendering them a model geriatric syndrome. Care of chronic wounds is interdisciplinary and involves nursing, nutrition, rehabilitation, and surgical subspecialties. Complications include pain, decreased quality of life, longer hospital stay, increased chance of readmission within 30 days after hospital discharge, increased chance of admission to a long-term care facility, and increased risk of death. Infectious complications include cellulitis, abscess, sepsis, pyarthrosis, osteomyelitis, and necrotizing soft tissue infection. Chronic wounds require surgical procedures including debridements, endovascular interventions, myocutaneous flaps, amputations, and ostomies for fecal diversion. A vexing variety of treatments is available with few studies to prove efficacy of one over the other. The standard of care for chronic wounds is evolving, and geriatricians need to be aware of prevention strategies, documentation standards, treatment choices, and how to co-manage wounds with other disciplines. Treatment strategies include a palliative care approach, which can avoid unnecessary and futile procedures, improve quality of life, preserve dignity, and curtail health care costs.

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Authors and Affiliations

  1. Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Jeffrey M. Levine

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  1. Jeffrey M. Levine
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Correspondence to Jeffrey M. Levine .

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Editors and Affiliations

  1. California Association of Long Term Care Medicine, Newbury Park, CA, USA

    Michael R. Wasserman

  2. Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, USA

    Debra Bakerjian

  3. Department of Clinical Pharmacy, University of Colorado School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA

    Sunny Linnebur

  4. Division of Geriatrics, SUNY Upstate Medical University, Syracuse, NY, USA

    Sharon Brangman

  5. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy

    Matteo Cesari

  6. Section of Geriatric Medicine, Division of Internal Medicine, Department of Medicine, Cedars-Sinai, Beverly Hills, CA, USA

    Sonja Rosen

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  1. Section of Geriatric Medicine, Division of Internal Medicine, Department of Medicine, Cedars-Sinai, Beverly Hills, CA, USA

    Sonja Rosen MD

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Levine, J.M. (2023). Pressure Injury and Chronic Wounds. In: Wasserman, M.R., Bakerjian, D., Linnebur, S., Brangman, S., Cesari, M., Rosen, S. (eds) Geriatric Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-01782-8_91-1

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