Colonization and infection
The population of elderly adults has been on a rise within the US, and this has been attributed to the improved healthcare system and especially on increased access to care for these populations. Within this perspective, life expectancy has increased and today the healthcare system is dominated by consumers within this category of elderly citizens (Koyano et al., 2014). Their risks of illness in this population is attributed to the aging mechanisms of tear and wear which therefore means that their systems and organs and particularly the defense mechanism tends to lose its agility with age. The one of the major challenges that these populations undergo is the cases of wounds. The incidences of frequent falls, functional loss, and incontinence issues are some of the risk factors that lead to incidences of wounds in the elderly population (Rayner, Carville, Leslie, & Roberts, 2015).
In the diagnosis of wounds in this population, the healthcare provider has to determine the causative factors as well as the stage of the wound in order to determine the most appropriate response or medication. In the elderly, we have to recognize that wounds tend to progress from the normal wound to the chronic wound and this is attributed to the reluctant nature of managing the wound right from colonization to infection. A colonized wound typically implies one where there is a high presence of proliferating bacteria but there is a lacking host response. In this state, the wound is likely to heal and is some cases, the bacteria can accelerate healing. However, with an infected wound, the bacteria not only exist on the wound but also tend to invade the underlying tissues thus eliciting the response of the host (Rayner, Carville, Leslie, & Roberts, 2015). Colonized wounds are at risk of infection mainly due to the continued exposure and lack of appropriate dressing and cleaning over the course of time when the wound is in the colonization stage. Apparently, it is difficult for the care provider to determine out rightly when the wound is in colonization or infection stage and therefore a multipronged approach including appropriate dressing, washing of the wound with antiseptics and regular undressing can help prevent the progression to chronic wound considering the slow healing mechanism in elderly groups (Koyano et al., 2014).
Type of skin wound
Bruises form one of the prominent wounds that may present with patients and particularly in elderly adults. It is normally described as a discoloration of the skin that occurs as a result of the breakage of blood vessels and the ultimate leaking of blood into the adjacent tissues under the skin. In older adults it could occur as a result of persistent pressure on the body or a fall that causes significant injury to the underlying blood vessels. Normally, bruises may not need or require treatment. However when dealing with older adults is it important to recognize that there is the aspect of slow healing mechanism and thus the risk of further injuries of the bruised region or apparent infection due to hygiene issues (Rayner, Carville, Leslie, & Roberts, 2015).
In treatment and management of bruises, the first step is to clean the affected region with an antiseptic to eliminate any possible disease-causing bacteria that might have landed on the site. A gentle cleansing of the wound with cool water and some soap and followed by a hydrogen peroxide flush can is the second important phase. For a bruise with regions of broken skin, alcohol should not be used as a replacement for hydrogen peroxide (Rayner, Carville, Leslie, & Roberts, 2015). The next step is to take a clean, sterile and cold pad and applying pressure on the region for some time to initiate vasoconstriction and therefore less inflammation. The next step is to apply some antibiotic ointment on the affected part and ultimately covering the region with a sterile adhesive dressing until a time when a scab or a clot forms during which the dressing can be removed and the bruised area left to heal.
Factors associated with emergence of bruises
Bruises in older adults are mainly as a result of the shrinking of the skin which ultimately implies that the skin loses its elasticity and therefore sags. With time, it becomes wrinkled, dry and scaly and when a little pressure due to a fall or a knock by furniture occurs, the blood vessels which are by now easily exposed will rupture. In some instances, elder abuse or neglect can be linked to the incidences of bruises. The modification of the environment where these people live, the modification of walking rails and training them on walking and balancing can be effective measures to prevent incidences of bruises (Koyano et al., 2014).
References
Koyano, Y., Nakagami, G., Iizaka, S., Minematsu, T., Noguchi, H., Tamai, N., & Murayama, R. (2014). Exploring the prevalence of skin tears and skin properties related to skin tears in elderly patients at a long‐term medical facility in Japan. International wound journal.
Rayner, R., Carville, K., Leslie, G., & Roberts, P. (2015). A review of patient and skin characteristics associated with skin tears. Journal of wound care, 24(9).
