‘Elderly' Patient Is Not Equal to ‘Geriatric' Patient - the People 90 Years or Older Who Visit Our Department of Plastic Surgery -

[Introduction]

Recently, in the developed countries led by the OECD members, the aging of population is remarkable. The average life expectancy continues lengthening year by year[1]. According to the latest statistics, the average life span of the Japanese women is 86.83 years old (first place of the world) and that of American women is 81.2 years old. Furthermore, the extension of healthy life expectancy is a global trend at the same time. In the area of plastic surgery, the opportunities when what we call ‘oldest old’ people (90 years of age or older) visit our out-patient departments increased. Conservative treatments and observations were often chosen by the reason of advanced age before, but elderly people under active treatments are increasing recently. We verified plastic surgeon’s involvement with super-aged patients.

[Patients and Methods]

The super elderly persons (above 90 y/o) who visited our department with all kinds of chief complaints from April 2013 to January 2016 were reviewed retrospectively.

 [Results]

The review identified a total of 53 patients. The average age at the time of the first medical examination is 93.13 years old (the most advanced age: 101 y/o). The ratio of men to women is 19 to 34. The distribution of lesions: head and neck(25), limb(24), trunk(4). Especially, problems about cheek or forehead are many strikingly. The categories of disease: injury(18), tumor(18), ulcer/decubitus(13), inflammatory disease(4). The diagnosis: chronic ulcer, contusion and keratoacanthoma are highlighted. There are eight patients of the malignant tumor. Some kind of surgeries were performed to 30 patients without any serious complications.

[Discussion]

It is not rare anymore that patients 90 years or older are treated in plastic surgery. Formerly, the problems of spare ability, understanding and balance with the remaining days became their hindrance. Therefore, the aggressive treatment for them had been ever evaded. However, a low-invasive treatment may not be necessarily a light burden to the patient or his family. There are developments of the perioperative care medicine and the rise in healthy life expectancy recently[2].

[Conclusion]

The super-advanced age will not become the reason to hesitate about active treatments in near future. Plastic surgeons can give the elderly and their neighboring people benefits by operations, hence contribute our aging society.