Approach to skin ulcers in older patients.
OBJECTIVE
To provide family physicians with an approach to managing skin ulcers in older patients.


METHODS
Clinical practice guidelines and best practice guidelines were summarized to describe an evidence-based approach. MAIN MESSAGE; Preventing ulcers is important in frail older patients. Using guidelines can help prevent ulcers in institutions. Clarifying the cause and contributing factors is the first step in management. Pressure and venous ulcers are common in elderly people. Poor nutrition, edema, arterial insufficiency, and anemia often impair wound healing. Adequate debridement is important to decrease risk of infection and to promote healing. There are guidelines for cleaning ulcers. Choice of dressings depends on the circumstances of each wound, but dressings should provide a moist environment. Options for dressings are summarized.


CONCLUSIONS
Family physicians can manage skin ulcers effectively by applying basic principles and using readily available guidelines.
Frank
Christopher
C
Department of Medicine, Division of Geriatrics, Queen's University, Kingston, ON. frankc@pccchealth.org
D000367:Age Factors; D000368:Aged; D047070:Bandages, Hydrocolloid; D003646:Debridement; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D016330:Frail Elderly; D006801:Humans; D008297:Male; D009779:Occlusive Dressings; D003668:Pressure Ulcer / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy; D012307:Risk Factors; D012883:Skin Ulcer / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control / Q000601:surgery / Q000628:therapy*; D013997:Time Factors; D014945:Wound Healing