Optimizing Postoperative Wound Healing for Older Lung Cancer Patients

Older adults undergoing surgery for lung cancer face heightened risks during postoperative recovery, and new research highlights the critical role nursing care plays in shaping wound healing and infection outcomes in this vulnerable population. A team of researchers from China conducted the study and published the results in BMC Geriatrics. It was important to conduct the study because the impact of targeted nursing interventions for this patient population “remains understudied,” according to investigators. In their retrospective case-control study, investigators leveraged data on “patient demographics, disease-related features, surgical and clinical parameters, postoperative biomarkers, complications, and nursing interventions” to inform the analysis. A variety of statistical measurements, including correlation analysis and logistic regression, were conducted to “investigate the associations and predictive values of various factors with postoperative wound healing and infection risk.” A total of 303 patients were enrolled in the study, and they were classified according to good or poor wound healing, with 197 and 106 patients in each group, respectively. The patients were further divided by postoperative infection status, with 275 patients in the non-infection cohort and 28 patients in the infection cohort. Patient age and the Charlson Comorbidity Index revealed “significance in postoperative wound healing.” The results showed that other disease-related features such as disease stage, histologic type, and diabetes “were associated with wound healing and infection risk.” Other factors that were associated with wound healing included duration of surgery, blood loss during the operation, postsurgical complications, and certain biomarkers. The investigators also evaluated postoperative complications across wound healing cohorts and found that complications such as pneumonia, atelectasis, infection, and pleural effusion were more common among patients in the poor wound healing group. In contrast, the good wound healing group was characterized by the implementation of nursing interventions, such as early activity, nutritional support, pain management, and antibiotic prophylaxis. Overall, age, comorbidities, as measured by the Charlson Comorbidity Index, and more advanced lung cancer stage were determined to be “significant predictors of poor wound healing.” “Early mobilization (85.28% versus 70.75%), nutritional support, pain management, and antibiotic prophylaxis demonstrated protective effects against poor wound healing and infection in elderly lung cancer patients,” the investigators concluded.