Age-related changes in wound healing.

Knowledge of the physiology of wound healing, in particular the recovery of the dermal and epidermal compartments and the co-ordination of these processes by the cytokine network, is of great importance to rational wound management. The individual components of the wound healing process have been studied using various in vitro and in vivo models, comparing young, adult and aged individuals. Many of the processes involved in wound healing are impaired in the elderly. However, in elderly patients not suffering from concomitant diseases, the rate of wound healing is normal or only slightly reduced. Various 'systemic factors' (endocrine and haematological diseases, nutritional deficiencies and medications) and 'regional disorders' (vascular and neural diseases) may impair wound healing. These complicating conditions occur more frequently in aged subjects. Failure of wound healing in the elderly is a chronic disabling condition, which occurs frequently in our society, requiring a major investment of medical care.