© Borgis - Postępy Nauk Medycznych 12/2008, s. 822
In issue 12 six papers are published connected with surgical treatment of patients in advanced age. The papers concern problems of flatal and faecal incontinence, injuries and multifaceted perioperative and post-operative rehabilitation – respiratory, motor and psychological rehabilitation. The problem of bedsores is also discuss.
Faecal incontinence is an embarrassing but very frequent problem in an ageing society. Faecal incontinence is frequently the cause of isolation of ill persons; it is even a basis to place them in care homes, in which the frequency of incontinence is assessed at 50% of residents. The authors of the article on faecal incontinence discuss causes, pathomechanism and methods of treatment. Modification of diet, drugs or biofeedback exercises often reduce the unpleasantness of faecal incontinence. Surgical treatment is recommended in precisely selected cases and should be carried out in reference centres providing coloproctology.
Older people have injuries more often than younger individuals. Because of the consequences of injuries patients in advanced age are hospitalized twice as often as younger people. Insufficiency of numerous organs in patients in advanced age increases post-traumatic prevalence; this concerns in particular hypoventilation, hypotension and consciousness disorders. Falls are the most frequent causes of injuries in people in advanced age. The most typical injuries for advanced age are rib fractures, head injuries, and fractures of the spine, thigh bone and radial bone. The basis for treatment success in older patients is early surgical treatment, appropriate and competent anaesthetization, and perioperative and post-operative rehabilitation.
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