| Epidemiology and Quality of Life |
What is the burden of illness due to chronic wounds in populations of older adults? What is the frequency of multiple wounds and recurrent wounds in older adults? What is the reason for racial and ethnic disparities in prevention and management of chronic wounds in older adults? What is the impact of wound-associated pain on quality of life and function? What are the effects of other comorbidities in conjunction with chronic wounds, with respect to quality of life? What are the effects of socioeconomic status, living status, and other social factors on chronic wounds and quality of life? How does adhering to evidence-based clinical guidelines affect complications and quality of life? Does healing a chronic wound necessarily improve quality of health? What is the impact of treatment regimens or evidence based guidelines for chronic wounds on quality of life?
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| Basic Biology of Wound Healing, Chronic Wounds, and Aging |
What causes acute injuries to become chronic wounds? How can immune cells in the wound environment, or recruitment of immune cells to the wound, be modulated to harness benefit? What strategies can be used to reverse macrophage impairment? What factors regulate or activate macrophage phenotype in wound repair? What are the mechanisms underlying endothelial and epidermal stem cell activation and homing to the wound site? What are the roles of proliferation and apoptosis in acute versus chronic wounds? What are reasons for delayed chemotaxis and decreased neutrophil function in chronic wounds? How does neutrophil depletion delay wound closure with advanced age? What are the mechanisms for MMP overproduction with aging in chronic wounds? What drives the changing composition and properties of ECM during development and aging? What are the relative contributions of aging and co-morbidities to the development of chronic wounds?
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| Molecular and Cellular Processes, Inflammation |
What mechanisms contribute to reduced HIF1α expression? Does aging alter TGF-β signaling in chronic wounds? How important are changes in inflammatory responses to age-related changes in wound healing? How does inflammation affect the wound healing process in older adults? What is the optimal inflammatory response that will support rapid repair, yet effectively reduce infection? Can chronic wounds be forced to heal by manipulating inflammation alone?
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| Molecular and Cellular Processes, Oxidative Stress |
What is the role of specific mitochondrial DNA damage in impaired skin healing?
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| Molecular and Cellular Processes, Microbial Burden |
Which microbiota are beneficial, and which are problematic for wound healing? How are systemic and local immune responses influenced by microbial bioburden in the wound? How does age influence microbial burden in wounds and subsequent wound healing?
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| Clinical Care, General |
What is the clinical significance of delayed wound healing in older adults? What is the significance of delayed wound healing from the patient’s point of view? Should wound care guidelines differ for older adults, accounting for heterogeneity and quality of life?
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| Clinical Care, Novel Therapeutic Approaches |
What interventions effectively improve microcirculation and wound healing with aging? What is the impact of wound therapies on universal patient outcomes, such as functional status, pain, physical impairment, mobility, and cognitive impairment, as opposed to wound-specific outcomes? What is the effect of multi-component interventions on patient- and wound-specific outcomes? Are there special considerations related to older patients with chronic wounds and dementia? During surgery, what steps can anesthesiologists take to mitigate risk for chronic or non-healing wounds? How do various wound treatments affect microbial burden? What new therapeutics can be developed based on the microbiome? How should cellular therapy be positioned in wound care? What potency assays are available to regulate cellular therapies? What is the effectiveness of physical modalities such as electrical stimulation and ultrasound in older adults? What is the impact of exercise on wound healing? What interventions effectively prevent chronic wounds in older adults?
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| Clinical Care, Nutrition |
Can patients be better categorized on the spectrum from cachexia to starvation, and can this categorization aid in determining the most effective nutritional treatment strategies? What is the optimal protein and energy intake for older adults with chronic wounds, especially at weight extremes? Is there a role for complete and various modular nutritional supplements, vitamin and mineral supplementation above the U.S. recommended daily intake, or appetite stimulants and anabolic steroids in the care of patients with chronic wounds? Are complete or modular commercial nutritional supplements better than regular foods?
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