Musculoskeletal And Integumentary Systems
I. Bentov, M. Reed
Published 2018 · Medicine
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Anesthesia and surgery directly affect the musculoskeletal and integumentary systems and expose the patient to potential risks of nerve injury, pressure ulcers, and surgical site infection. Older age is a risk factor for all of them. Aging is accompanied by changes to the structure and function of the skin that negatively impact the three stages of incisional wound healing, inflammation, tissue formation, and remodeling, leading to an increased risk of surgical wound infection. Surgical wound infection is associated with considerable suffering and leads to an increase in costs, morbidity, and mortality. Anesthesiologists provide clinical interventions that can improve wound healing and reduce the risk of surgical site infections. Interventions include preoperative consulting for smoking cessation and physical activity, administration of antibiotics and oxygen, and management of blood glucose, body temperature, and fluids. It is also possible that choice of anesthetic technique and drugs may also influence wound healing. Aging is also associated with sarcopenia (loss of muscle mass) and osteoarthritis, which are important to recognize in order to reduce the incidence of perioperative pressure ulcers and nerve injuries.
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