Chronic wound repair and healing in older adults: current status and future research.

Older adults are more likely to have chronic wounds than younger people, and the effect of chronic wounds on quality of life is particularly profound in this population. Wound healing slows with age, but the basic biology underlying chronic wounds and the influence of age-associated changes on wound healing are poorly understood. Most studies have used in vitro approaches and various animal models, but observed changes translate poorly to human healing conditions. The effect of age and accompanying multimorbidity on the effectiveness of existing and emerging treatment approaches for chronic wounds is also unknown, and older adults tend to be excluded from randomized clinical trials. Poorly defined outcomes and variables; lack of standardization in data collection; and variations in the definition, measurement, and treatment of wounds also hamper clinical studies. The Association of Specialty Professors, in conjunction with the National Institute on Aging and the Wound Healing Society, held a workshop, summarized in this article, to explore the current state of knowledge and research challenges, engage investigators across disciplines, and identify research questions to guide future study of age-associated changes in chronic wound healing.

Preoperative physical activity, anesthesia, and analgesia: effects on early postoperative walking after total hip replacement.

This study explored whether preoperative activity, anesthesia, or analgesia influence early postoperative walking after total hip replacement (THR). Data were collected as part of a randomized intervention study of standard or augmented postoperative activity and its influence on wound healing. More than half of all subjects did not exercise regularly. Subjects who performed strength activities preoperatively walked significantly greater distances. Anesthesia or analgesia did not affect walking distances. Upper arm strength is needed after THR because walking is dependent on the use of assistive devices. These results suggest: (1) preoperative exercise may promote recovery of mobility after THR, and (2) a need to evaluate preoperative exercise programs for effect on mobility and independence after THR.