Skip to main content
SpringerLink
Log in
Book cover

Geriatric Anesthesiology pp 203–212Cite as

Musculoskeletal and Integumentary Systems

  • Chapter
  • First Online:

  • 1323 Accesses

Abstract

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.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Clarys J, Martin A, Drinkwater D. Gross tissue weights in the human body by cadaver dissection. Hum Biol. 1984;56(3):459–73.

    CAS  PubMed  Google Scholar 

  2. Bentov I, Reed MJ. Anesthesia, microcirculation, and wound repair in aging. Anesthesiology. 2014;120(3):760–72.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Zouboulis CC, Makrantonaki E. Clinical aspects and molecular diagnostics of skin aging. Clin Dermatol. 2011;29(1):3–14.

    Article  PubMed  Google Scholar 

  4. Montagna W, Carlisle K. Structural changes in ageing skin. Br J Dermatol. 1990;122(Suppl 35):61–70.

    Article  PubMed  Google Scholar 

  5. Bentov I, Reed MJ. The effect of aging on the cutaneous microvasculature. Microvasc Res. 2015;100:25–31.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Rooke GA, Savage MV, Brengelmann GL. Maximal skin blood flow is decreased in elderly men. J Appl Physiol. 1994;77(1):11–4.

    CAS  PubMed  Google Scholar 

  7. Tsuchida Y. The effect of aging and arteriosclerosis on human skin blood flow. J Dermatol Sci. 1993;5(3):175–81.

    Article  CAS  PubMed  Google Scholar 

  8. Pessaux P, Msika S, Atalla D, Hay J, Flamant Y, The French Associations for Surgical Research. Risk factors for postoperative infectious complications in noncolorectal abdominal surgery: a multivariate analysis based on a prospective multicenter study of 4718 patients. Arch Surg. 2003;138(3):314–24.

    Article  PubMed  Google Scholar 

  9. Korol E, Johnston K, Waser N, et al. A systematic review of risk factors associated with surgical site infections among surgical patients. PLoS One. 2013;8(12):e83743.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  10. Kaye KS, Schmit K, Pieper C, et al. The effect of increasing age on the risk of surgical site infection. J Infect Dis. 2005;191(7):1056–62.

    Article  PubMed  Google Scholar 

  11. Kaye KS, Anderson DJ, Sloane R, et al. The effect of surgical site infection on older operative patients. J Am Geriatr Soc. 2009;57(1):46–54.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Singer AJ, Clark RA. Cutaneous wound healing. N Engl J Med. 1999;341(10):738–46.

    Article  CAS  PubMed  Google Scholar 

  13. Reed MJ, Karres N, Eyman D, Vernon RB, Edelberg JM. Age-related differences in repair of dermal wounds and myocardial infarcts attenuate during the later stages of healing. In Vivo. 2006;20(6B):801–6.

    PubMed  Google Scholar 

  14. Tarnuzzer RW, Schultz GS. Biochemical analysis of acute and chronic wound environments. Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society. 1996;4(3):321–5.

    Article  CAS  Google Scholar 

  15. Swift ME, Burns AL, Gray KL, DiPietro LA. Age-related alterations in the inflammatory response to dermal injury. J Invest Dermatol. 2001;117(5):1027–35.

    Article  CAS  PubMed  Google Scholar 

  16. Hsieh MM, Everhart JE, Byrd-Holt DD, Tisdale JF, Rodgers GP. Prevalence of neutropenia in the U.S. population: age, sex, smoking status, and ethnic differences. Ann Intern Med. 2007;146(7):486–92.

    Article  PubMed  Google Scholar 

  17. Silverman EM, Silverman AG. Granulocyte adherence in the elderly. Am J Clin Pathol. 1977;67(1):49–52.

    Article  CAS  PubMed  Google Scholar 

  18. Butcher SK, Chahal H, Nayak L, et al. Senescence in innate immune responses: reduced neutrophil phagocytic capacity and CD16 expression in elderly humans. J Leukoc Biol. 2001;70(6):881–6.

    CAS  PubMed  Google Scholar 

  19. Emery CF, Kiecolt-Glaser JK, Glaser R, Malarkey WB, Frid DJ. Exercise accelerates wound healing among healthy older adults: a preliminary investigation. J Gerontol A Biol Sci Med Sci. 2005;60(11):1432–6.

    Article  PubMed  Google Scholar 

  20. Clark RA. Basics of cutaneous wound repair. J Dermatol Surg Oncol. 1993;19(8):693–706.

    Article  CAS  PubMed  Google Scholar 

  21. Gillitzer R, Goebeler M. Chemokines in cutaneous wound healing. J Leukoc Biol. 2001;69(4):513–21.

    CAS  PubMed  Google Scholar 

  22. McClain SA, Simon M, Jones E, et al. Mesenchymal cell activation is the rate-limiting step of granulation tissue induction. Am J Pathol. 1996;149(4):1257–70.

    CAS  PubMed  PubMed Central  Google Scholar 

  23. Mussini E, Hutton JJ Jr, Udenfriend S. Collagen proline hydroxylase in wound healing, granuloma formation, scurvy, and growth. Science. 1967;157(3791):927–9.

    Article  CAS  PubMed  Google Scholar 

  24. Holt DR, Kirk SJ, Regan MC, Hurson M, Lindblad WJ, Barbul A. Effect of age on wound healing in healthy human beings. Surgery. 1992;112(2):293–7. discussion 297-298

    CAS  PubMed  Google Scholar 

  25. Rivard A, Fabre JE, Silver M, et al. Age-dependent impairment of angiogenesis. Circulation. 1999;99(1):111–20.

    Article  CAS  PubMed  Google Scholar 

  26. Arthur WT, Vernon RB, Sage EH, Reed MJ. Growth factors reverse the impaired sprouting of microvessels from aged mice. Microvasc Res. 1998;55(3):260–70.

    Article  CAS  PubMed  Google Scholar 

  27. Reiser K, McGee C, Rucker R, McDonald R. Effects of aging and caloric restriction on extracellular matrix biosynthesis in a model of injury repair in rats. J Gerontol A Biol Sci Med Sci. 1995;50A(1):B40–7.

    Article  CAS  PubMed  Google Scholar 

  28. Ashcroft GS, Dodsworth J, van Boxtel E, et al. Estrogen accelerates cutaneous wound healing associated with an increase in TGF-beta1 levels. Nat Med. 1997;3(11):1209–15.

    Article  CAS  PubMed  Google Scholar 

  29. Reed MJ, Vernon RB, Abrass IB, Sage EH. TGF-beta 1 induces the expression of type I collagen and SPARC, and enhances contraction of collagen gels, by fibroblasts from young and aged donors. J Cell Physiol. 1994;158(1):169–79.

    Article  CAS  PubMed  Google Scholar 

  30. Gillis C, Li C, Lee L, et al. Prehabilitation versus rehabilitation: a randomized control trial in patients undergoing colorectal resection for cancer. Anesthesiology. 2014;121(5):937–47.

    Article  PubMed  Google Scholar 

  31. Lemanu D, Singh P, MacCormick A, Arroll B, Hill A. Effect of preoperative exercise on cardiorespiratory function and recovery after surgery: a systematic review. World J Surg. 2013;37(4):711–20.

    Article  PubMed  Google Scholar 

  32. Donohue JF. Ageing, smoking and oxidative stress. Thorax. 2006;61(6):461–2.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Valdes A, Andrew T, Gardner J, et al. Obesity, cigarette smoking, and telomere length in women. Lancet. 2005;366(9486):662–4.

    Article  CAS  PubMed  Google Scholar 

  34. Leung WC, Harvey I. Is skin ageing in the elderly caused by sun exposure or smoking? Br J Dermatol. 2002;147(6):1187–91.

    Article  PubMed  Google Scholar 

  35. Buckland A, Connolly MJ. Age-related differences in smoking cessation advice and support given to patients hospitalised with smoking-related illness. Age Ageing. 2005;34(6):639–42.

    Article  PubMed  Google Scholar 

  36. Lehr HA. Microcirculatory dysfunction induced by cigarette smoking. Microcirculation. 2000;7(6 Pt 1):367–84.

    Article  CAS  PubMed  Google Scholar 

  37. Sorensen LT. Wound healing and infection in surgery. The clinical impact of smoking and smoking cessation: a systematic review and meta-analysis. Arch Surg. 2012;147(4):373–83.

    Article  PubMed  Google Scholar 

  38. Schiattarella GG, Perrino C, Magliulo F, et al. Physical activity in the prevention of peripheral artery disease in the elderly. Front Physiol. 2014;5:12.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Taddei S, Galetta F, Virdis A, et al. Physical activity prevents age-related impairment in nitric oxide availability in elderly athletes. Circulation. 2000;101(25):2896–901.

    Article  CAS  PubMed  Google Scholar 

  40. Wang JS, Lan C, Wong MK. Tai chi Chuan training to enhance microcirculatory function in healthy elderly men. Arch Phys Med Rehabil. 2001;82(9):1176–80.

    Article  CAS  PubMed  Google Scholar 

  41. Emery CF, Kiecolt-Glaser JK, Glaser R, Malarkey WB, Frid DJ. Exercise accelerates wound healing among healthy older adults: a preliminary investigation. J Gerontol Ser A Biol Med Sci. 2005;60(11):1432–6.

    Article  Google Scholar 

  42. Ramos M, Khalpey Z, Lipsitz S, et al. Relationship of perioperative hyperglycemia and postoperative infections in patients who undergo general and vascular surgery. Ann Surg. 2008;248(4):585–91.

    PubMed  Google Scholar 

  43. Van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in critically ill patients. N Engl J Med. 2001;345(19):1359–67.

    Article  PubMed  Google Scholar 

  44. Furnary AP, Zerr KJ, Grunkemeier GL, Starr A. Continuous intravenous insulin infusion reduces the incidence of deep sternal wound infection in diabetic patients after cardiac surgical procedures. Ann Thorac Surg. 1999;67(2):352–60.

    Article  CAS  PubMed  Google Scholar 

  45. Van den Berghe G. How does blood glucose control with insulin save lives in intensive care? J Clin Invest. 2004;114(9):1187–95.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Ismail-Beigi F, Craven T, Banerji MA, et al. Effect of intensive treatment of hyperglycaemia on microvascular outcomes in type 2 diabetes: an analysis of the ACCORD randomised trial. Lancet. 2010;376(9739):419–30.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Buchleitner AM, Martinez-Alonso M, Hernandez M, Sola I, Mauricio D. Perioperative glycaemic control for diabetic patients undergoing surgery. Cochrane Database Syst Rev. 2012;9:CD007315.

    Google Scholar 

  48. Matyka K, Evans M, Lomas J, Cranston I, Macdonald I, Amiel SA. Altered hierarchy of protective responses against severe hypoglycemia in normal aging in healthy men. Diabetes Care. 1997;20(2):135–41.

    Article  CAS  PubMed  Google Scholar 

  49. Duggan EW, Carlson K, Umpierrez GE. Perioperative hyperglycemia management: an update. Anesthesiology. 2017;126(3):547–60.

    Article  PubMed  Google Scholar 

  50. Bratzler DW, Houck PM, Surgical Infection Prevention Guidelines Writers Workgroup, et al. Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Clin Infect Dis : an official publication of the Infectious Diseases Society of America. 2004;38(12):1706–15.

    Article  Google Scholar 

  51. Silber JH, Rosenbaum PR, Trudeau ME, et al. Preoperative antibiotics and mortality in the elderly. Ann Surg. 2005;242(1):107–14.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Bode LGM, Kluytmans JAJW, Wertheim HFL, et al. Preventing surgical-site infections in nasal carriers of Staphylococcus Aureus. N Engl J Med. 2010;362(1):9–17.

    Article  CAS  PubMed  Google Scholar 

  53. Perl TM, Cullen JJ, Wenzel RP, et al. Intranasal Mupirocin to prevent postoperative Staphylococcus Aureus infections. N Engl J Med. 2002;346(24):1871–7.

    Article  CAS  PubMed  Google Scholar 

  54. Tandara AA, Mustoe TA. Oxygen in wound healing–more than a nutrient. World J Surg. 2004;28(3):294–300.

    Article  PubMed  Google Scholar 

  55. Sundaresan M, Yu ZX, Ferrans VJ, et al. Regulation of reactive-oxygen-species generation in fibroblasts by Rac1. Biochem J. 1996;318(Pt 2):379–82.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Babior BM. Oxygen-dependent microbial killing by phagocytes (first of two parts). N Engl J Med. 1978;298(12):659–68.

    Article  CAS  PubMed  Google Scholar 

  57. Hopf HW, Hunt TK, West JM, et al. Wound tissue oxygen tension predicts the risk of wound infection in surgical patients. Arch Surg. 1997;132(9):997–1004. discussion 1005

    Article  CAS  PubMed  Google Scholar 

  58. Qadan M, Akca O, Mahid SS, Hornung CA, Polk HC Jr. Perioperative supplemental oxygen therapy and surgical site infection: a meta-analysis of randomized controlled trials. Arch Surg. 2009;144(4):359–66. discussion 366-357

    Article  PubMed  Google Scholar 

  59. Togioka B, Galvagno S, Sumida S, Murphy J, Ouanes JP, Wu C. The role of perioperative high inspired oxygen therapy in reducing surgical site infection: a meta-analysis. Anesth Analg. 2012;114(2):334–42.

    Article  CAS  PubMed  Google Scholar 

  60. Greif R, Akca O, Horn EP, Kurz A, Sessler DI, Outcomes RG. Supplemental perioperative oxygen to reduce the incidence of surgical-wound infection. N Engl J Med. 2000;342(3):161–7.

    Article  CAS  PubMed  Google Scholar 

  61. Belda FJ, Aguilera L, de la Asuncion JG, et al. Supplemental perioperative oxygen and the risk of surgical wound infection: a randomized controlled trial. JAMA. 2005;294(16):2035–42.

    Article  CAS  PubMed  Google Scholar 

  62. Pryor KO, Fahey TJ 3rd, Lien CA, Goldstein PA. Surgical site infection and the routine use of perioperative hyperoxia in a general surgical population: a randomized controlled trial. JAMA. 2004;291(1):79–87.

    Article  CAS  PubMed  Google Scholar 

  63. Meyhoff CS, Wetterslev J, Jorgensen LN, et al. Effect of high perioperative oxygen fraction on surgical site infection and pulmonary complications after abdominal surgery: the PROXI randomized clinical trial. JAMA. 2009;302(14):1543–50.

    Article  CAS  PubMed  Google Scholar 

  64. Guenard H, Marthan R. Pulmonary gas exchange in elderly subjects. Eur Respir J. 1996;9(12):2573–7.

    Article  CAS  PubMed  Google Scholar 

  65. McGuire DK, Levine BD, Williamson JW, et al. A 30-year follow-up of the Dallas Bedrest and training study: I. Effect of age on the cardiovascular response to exercise. Circulation. 2001;104(12):1350–7.

    Article  CAS  PubMed  Google Scholar 

  66. Poole D, Behnke B, Musch T. Capillary hemodynamics and oxygen pressures in the aging microcirculation. Microcirculation. 2006;13(4):289–99.

    Article  PubMed  CAS  Google Scholar 

  67. McGee S, Abernethy WB 3rd, Simel DL. The rational clinical examination. Is this patient hypovolemic? JAMA. 1999;281(11):1022–9.

    Article  CAS  PubMed  Google Scholar 

  68. Arkilic CF, Taguchi A, Sharma N, et al. Supplemental perioperative fluid administration increases tissue oxygen pressure. Surgery. 2003;133(1):49–55.

    Article  PubMed  Google Scholar 

  69. Brandstrup B, Tonnesen H, Beier-Holgersen R, et al. Effects of intravenous fluid restriction on postoperative complications: comparison of two perioperative fluid regimens: a randomized assessor-blinded multicenter trial. Ann Surg. 2003;238(5):641–8.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Stotts NA, Hopf HW. The link between tissue oxygen and hydration in nursing home residents with pressure ulcers: preliminary data. J Wound Ostomy Continence Nurs : official publication of The Wound, Ostomy and Continence Nurses Society / WOCN. 2003;30(4):184–90.

    Google Scholar 

  71. Stotts NA, Hopf HW, Kayser-Jones J, Chertow GM, Cooper BA, Wu HS. Increased fluid intake does not augment capacity to lay down new collagen in nursing home residents at risk for pressure ulcers: a randomized, controlled clinical trial. Wound Repair Regen:official publication of the Wound Healing Society [and] the European Tissue Repair Society. 2009;17(6):780–8.

    Article  Google Scholar 

  72. Spahn DR, Chassot PG. CON: fluid restriction for cardiac patients during major noncardiac surgery should be replaced by goal-directed intravascular fluid administration. Anesth Analg. 2006;102(2):344–6.

    Article  PubMed  Google Scholar 

  73. Sinclair S, James S, Singer M. Intraoperative intravascular volume optimisation and length of hospital stay after repair of proximal femoral fracture: randomised controlled trial. BMJ. 1997;315(7113):909–12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  74. Endres HG, Wedding U, Pittrow D, Thiem U, Trampisch HJ, Diehm C. Prevalence of anemia in elderly patients in primary care: impact on 5-year mortality risk and differences between men and women. Curr Med Res Opin. 2009;25(5):1143–58.

    Article  PubMed  Google Scholar 

  75. Wu WC, Schifftner TL, Henderson WG, et al. Preoperative hematocrit levels and postoperative outcomes in older patients undergoing noncardiac surgery. JAMA. 2007;297(22):2481–8.

    Article  CAS  PubMed  Google Scholar 

  76. Dunne JR, Malone D, Tracy JK, Gannon C, Napolitano LM. Perioperative anemia: an independent risk factor for infection, mortality, and resource utilization in surgery. J Surg Res. 2002;102(2):237–44.

    Article  PubMed  Google Scholar 

  77. Sessler DI. Mild perioperative hypothermia. N Engl J Med. 1997;336(24):1730–7.

    Article  CAS  PubMed  Google Scholar 

  78. Frank SM, Beattie C, Christopherson R, et al. Epidural versus general anesthesia, ambient operating room temperature, and patient age as predictors of inadvertent hypothermia. Anesthesiology. 1992;77(2):252–7.

    Article  CAS  PubMed  Google Scholar 

  79. Melling AC, Ali B, Scott EM, Leaper DJ. Effects of preoperative warming on the incidence of wound infection after clean surgery: a randomised controlled trial. Lancet. 2001;358(9285):876–80.

    Article  CAS  PubMed  Google Scholar 

  80. Hajat S, Kovats RS, Lachowycz K. Heat-related and cold-related deaths in England and Wales: who is at risk? Occup Environ Med. 2007;64(2):93–100.

    Article  CAS  PubMed  Google Scholar 

  81. Holowatz LA, Thompson-Torgerson C, Kenney WL. Aging and the control of human skin blood flow. Front Biosci. 2010;15:718–39.

    Article  CAS  Google Scholar 

  82. Kurz A, Plattner O, Sessler DI, Huemer G, Redl G, Lackner F. The threshold for thermoregulatory vasoconstriction during nitrous oxide/isoflurane anesthesia is lower in elderly than in young patients. Anesthesiology. 1993;79(3):465–9.

    Article  CAS  PubMed  Google Scholar 

  83. Ozaki M, Sessler DI, Matsukawa T, et al. The threshold for thermoregulatory vasoconstriction during nitrous oxide/sevoflurane anesthesia is reduced in the elderly. Anesth Analg. 1997;84(5):1029–33.

    Article  CAS  PubMed  Google Scholar 

  84. Vassilieff N, Rosencher N, Sessler DI, Conseiller C. Shivering threshold during spinal anesthesia is reduced in elderly patients. Anesthesiology. 1995;83(6):1162–6.

    Article  CAS  PubMed  Google Scholar 

  85. Carli F, Gabrielczyk M, Clark MM, Aber VR. An investigation of factors affecting postoperative rewarming of adult patients. Anaesthesia. 1986;41(4):363–9.

    Article  CAS  PubMed  Google Scholar 

  86. Moola S, Lockwood C. Effectiveness of strategies for the management and/or prevention of hypothermia within the adult perioperative environment. Int J Evid Based Healthc. 2011;9(4):337–45.

    Article  PubMed  Google Scholar 

  87. Kehlet H. Manipulation of the metabolic response in clinical practice. World J Surg. 2000;24(6):690–5.

    Article  CAS  PubMed  Google Scholar 

  88. Moraca RJ, Sheldon DG, Thirlby RC. The role of epidural anesthesia and analgesia in surgical practice. Ann Surg. 2003;238(5):663–73.

    Article  PubMed  PubMed Central  Google Scholar 

  89. Treschan TA, Taguchi A, Ali SZ, et al. The effects of epidural and general anesthesia on tissue oxygenation. Anesth Analg. 2003;96(6):1553–7. table of contents

    Article  PubMed  Google Scholar 

  90. Bagry H, de la Cuadra Fontaine JC, Asenjo JF, Bracco D, Carli F. Effect of a continuous peripheral nerve block on the inflammatory response in knee arthroplasty. Reg Anesth Pain Med. 2008;33(1):17–23.

    Article  PubMed  Google Scholar 

  91. Martin F, Martinez V, Mazoit JX, et al. Antiinflammatory effect of peripheral nerve blocks after knee surgery: clinical and biologic evaluation. Anesthesiology. 2008;109(3):484–90.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  92. O'Hara DA, Duff A, Berlin JA, et al. The effect of anesthetic technique on postoperative outcomes in hip fracture repair. Anesthesiology. 2000;92(4):947–57.

    Article  PubMed  Google Scholar 

  93. Roy RC. Choosing general versus regional anesthesia for the elderly. Anesthesiol Clin North Am. 2000;18(1):91–104. vii

    Article  CAS  Google Scholar 

  94. Chang CC, Lin HC, Lin HW, Lin HC. Anesthetic management and surgical site infections in total hip or knee replacement: a population-based study. Anesthesiology. 2010;113(2):279–84.

    Article  PubMed  Google Scholar 

  95. Brower MC, Johnson ME. Adverse effects of local anesthetic infiltration on wound healing. Reg Anesth Pain Med. 2003;28(3):233–40.

    Article  CAS  PubMed  Google Scholar 

  96. Bamigboye AA, Hofmeyr GJ. Local anaesthetic wound infiltration and abdominal nerves block during caesarean section for postoperative pain relief. Cochrane Database Syst Rev. 2009;3:CD006954.

    Google Scholar 

  97. Akca O, Melischek M, Scheck T, et al. Postoperative pain and subcutaneous oxygen tension. Lancet. 1999;354(9172):41–2.

    Article  CAS  PubMed  Google Scholar 

  98. Chvapil M, Hameroff SR, O'Dea K, Peacock EE Jr. Local anesthetics and wound healing. J Surg Res. 1979;27(6):367–71.

    Article  CAS  PubMed  Google Scholar 

  99. Lucchinetti E, Awad AE, Rahman M, et al. Antiproliferative effects of local anesthetics on mesenchymal stem cells: potential implications for tumor spreading and wound healing. Anesthesiology. 2012;116(4):841–56.

    Article  CAS  PubMed  Google Scholar 

  100. Bentov I, Damodarasamy M, Spiekerman C, Reed MJ. Lidocaine impairs proliferative and biosynthetic functions of aged human dermal fibroblasts. Anesth Analg. 2016;123(3):616–23.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  101. Nation RL, Triggs EJ, Selig M. Lignocaine kinetics in cardiac patients and aged subjects. Br J Clin Pharmacol. 1977;4(4):439–48.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  102. Black JM, Edsberg LE, Baharestani MM, et al. Pressure ulcers: avoidable or unavoidable? Results of the national pressure ulcer advisory panel consensus conference. Ostomy Wound Manage. 2011;57(2):24–37.

    PubMed  Google Scholar 

  103. Stoelting RK. Postoperative ulnar nerve palsy–is it a preventable complication? Anesth Analg. 1993;76(1):7–9.

    Article  CAS  PubMed  Google Scholar 

  104. O'Brien DD, Shanks AM, Talsma A, Brenner PS, Ramachandran SK. Intraoperative risk factors associated with postoperative pressure ulcers in critically ill patients: a retrospective observational study. Crit Care Med. 2014;42(1):40–7.

    Article  PubMed  Google Scholar 

  105. Reddy M, Gill SS, Rochon PA. Preventing pressure ulcers: a systematic review. JAMA. 2006;296(8):974–84.

    Article  CAS  PubMed  Google Scholar 

  106. McInnes E, Jammali-Blasi A, Bell-Syer SE, Dumville JC, Middleton V, Cullum N. Support surfaces for pressure ulcer prevention. Cochrane Database Syst Rev. 2015;9:CD001735.

    Google Scholar 

  107. Kroll DA, Caplan RA, Posner K, Ward RJ, Cheney FW. Nerve injury associated with anesthesia. Anesthesiology. 1990;73(2):202–7.

    Article  CAS  PubMed  Google Scholar 

  108. Lalkhen AG, Bhatia K. Perioperative Peripheral Nerve Injuries. Continuing Education in Anaesthesia, Critical Care and Pain 2012;12:38–42.

    Google Scholar 

  109. Radka N, Oldřich V, Edvard E, et al. The dependence of age on ulnar nerve conductive study parameter adaptation after compressive ulnar neuropathy operations in the elbow. Acta Neurochir. 2015;157(8):1405–9.

    Article  PubMed  Google Scholar 

  110. Patel HP, Syddall HE, Jameson K, et al. Prevalence of sarcopenia in community-dwelling older people in the UK using the European working group on sarcopenia in older people (EWGSOP) definition: findings from the Hertfordshire cohort study (HCS). Age Ageing. 2013;42(3):378–84.

    Article  PubMed  PubMed Central  Google Scholar 

  111. Doherty TJ. Invited review: aging and sarcopenia. J Appl Physiol. 2003;95(4):1717–27.

    Article  CAS  PubMed  Google Scholar 

  112. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol Ser A Biol Med Sci. 2001;56(3):M146–57.

    Article  CAS  Google Scholar 

  113. Denison HJ, Cooper C, Sayer AA, Robinson SM. Prevention and optimal management of sarcopenia: a review of combined exercise and nutrition interventions to improve muscle outcomes in older people. Clin Interv Aging. 2015;10:859–69.

    PubMed  PubMed Central  Google Scholar 

  114. Practice advisory for the prevention of perioperative peripheral neuropathies: a report by the American Society of Anesthesiologists Task Force on prevention of perioperative peripheral neuropathies. Anesthesiology. 2000;92(4):1168–82.

    Google Scholar 

  115. Loeser RF. Age-related changes in the musculoskeletal system and the development of osteoarthritis. Clin Geriatr Med. 2010;26(3):371–86.

    Article  PubMed  PubMed Central  Google Scholar 

  116. Lawrence RC, Felson DT, Helmick CG, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: part II. Arthritis Rheum. 2008;58(1):26–35.

    Article  PubMed  PubMed Central  Google Scholar 

  117. Gould L, Abadir P, Brem H, et al. Chronic wound repair and healing in older adults: current status and future research. J Am Geriatr Soc. 2015;63(3):427–38.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, Harborview Medical Center/University of Washington, Seattle, WA, USA

    Itay Bentov

  2. Department of Medicine, Harborview Medical Center/University of Washington School of Medicine, Seattle, WA, USA

    May J. Reed

Authors
  1. Itay Bentov
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. May J. Reed
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Itay Bentov .

Editor information

Editors and Affiliations

  1. Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, South Carolina, USA

    J. G. Reves

  2. Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA

    Sheila Ryan Barnett

  3. Department of Anesthesia and Perioperative Medicine, Department of Anesthesiology, Medical University of South Carolina, Charleston, South Carolina, USA

    Julie R. McSwain

  4. Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington, USA

    G. Alec Rooke

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Bentov, I., Reed, M.J. (2018). Musculoskeletal and Integumentary Systems. In: Reves, J., Barnett, S., McSwain, J., Rooke, G. (eds) Geriatric Anesthesiology. Springer, Cham. https://doi.org/10.1007/978-3-319-66878-9_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-66878-9_14

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-66877-2

  • Online ISBN: 978-3-319-66878-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation