“Sore” spots in healthcare: Wounds in old age
Why do wounds often heal so poorly in old age? The Ludwig Boltzmann Research Group on Ageing and Wound Healing has been investigating this question for four years. The team will conclude its research work at the end of September 2024. But the mission continues.
‘Every wound has a person attached to it,’ is something you often hear from professional wound carers. They are referring to the interpersonal, social and societal aspects of wound care. However, the statement is also highly relevant in medical terms. Because in order to explain the lack of wound healing in old age, you have to look at the body as a whole.
Before a chronic wound develops, something has usually already gone wrong in the body. A venous valve no longer closes, the blood builds up in the feet and legs. Or constrictions in the blood vessels no longer allow the blood to reach the feet. Vascular problems are the most common cause of wound healing disorders and chronic wounds. Diabetes and pressure sores caused by immobility also play a major role.
Successful wound treatment can therefore only work if it is approached holistically. The Research Group for Ageing and Wound Healing thinks one step further. Holistic does not have to stop at the body. The wholeness of carers from different professions and disciplines must also be considered. And thinking even bigger: the healthcare system, healthcare policy and the way we all understand wound healing.
Drawing on a multitude of experiences
In order to understand the big picture, it was crucial for the research group to always be in touch with the big picture. Many perspectives have found a place in the work of the research group over its lifetime – from leaders of international organisations to people affected by chronic wounds in the local neighbourhood. The aim of the research group is to bring people on board who have something to say and experience with chronic wounds and their treatment in order to jointly define the problems and develop solutions.
The numerous discussions resulted in a comprehensive report on the care of chronic wounds in the Austrian healthcare system in 2022, a scientific publication on the enormous value of coordination and relationship work in professional wound care in 2023 and a brochure this summer that accompanies people taking their first steps with a chronic wound. Over the years, this has resulted in a considerable network of input providers. In order to give something back to this network, and because knowledge always grows when it is shared, the research group organised the ‘Sore Spots’ forum in June. Over 100 participants took part, including researchers, practitioners, those affected and relatives.
Good coordination is crucial
The medical treatment of chronic wounds has many settings. The hospital room optimised for efficiency, the friendly, bright surgery of the GP, the cosy living room of the patient being cared for at home. Sometimes even a park bench. People encounter chronic wounds in all circumstances, even in difficult ones.
A shoe, worn for weeks, can hardly be taken off. The sock underneath is fused to the wound. The descriptions of Monika Stark, medical director of the Louisebus, litterally get ‘under the skin’. At the Caritas mobile medical care centre in Vienna, she catches people who fall through the system. That’s when a lot of trust is needed. That’s when it’s important to look beyond the wound and see patients as people in their entirety.
Seeing people is also incredibly important on the supply side. Just as there is a person behind every wound, there is also a person in every white coat and every medical glove. Wound care is a profession that requires a lot of interpersonal coordination. There are hardly any fixed structures. ‘Do we need to rethink job profiles in the future?’ was the big question in a round table discussion. ‘Can digitalisation pave the way for better wound care?’ was the topic of a series of lectures. DGKP Karoline Kinsky made a fiery plea for more basic digital education. ‘If someone is not familiar with the term ‘address bar’ in a browser, we don’t even need to talk about digital care,’ she pointedly addressed the fundamental hurdles of digitalisation.
For the Ludwig Boltzmann Research Group, the event is a complete success. For them, it is also a kind of passing of the baton. The contacts made in the course of their research work will no longer be bundled together, but will move closer together. In this way, the work will remain alive beyond the group.