Skip Navigation LinksHome > March 2014 - Volume 120 - Issue 3 > Anesthesia, Microcirculation, and Wound Repair in Aging
doi: 10.1097/ALN.0000000000000036
Education: Review Article

Anesthesia, Microcirculation, and Wound Repair in Aging

Bentov, Itay M.D., Ph.D.; Reed, May J. M.D.

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Age-related changes in skin contribute to impaired wound healing after surgical procedures. Changes in skin with age include decline in thickness and composition, a decrease in the number of most cell types, and diminished microcirculation. The microcirculation provides tissue perfusion, fluid homeostasis, and delivery of oxygen and other nutrients. It also controls temperature and the inflammatory response. Surgical incisions cause further disruption of the microvasculature of aged skin. Perioperative management can be modified to minimize insults to aged tissues. Judicious use of fluids, maintenance of normal body temperature, pain control, and increased tissue oxygen tension are examples of adjustable variables that support the microcirculation. Anesthetic agents influence the microcirculation of a combination of effects on cardiac output, arterial pressure, and local microvascular changes. The authors examined the role of anesthetic management in optimizing the microcirculation and potentially improving postoperative wound repair in older persons.

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