Preventing pressure injuries on the heels is critical for good patient care

Heel devices that address foot drop while effectively accommodating SCD devices warrant a closer look.

It is widely documented that the heel is the second most common site for pressure injuries. A prevalence study conducted over a 16-year period revealed that heel ulcers accounted for 34% of all PIs in bedridden patients. And 41% of all deep tissue injuries also manifest on the heel. But, why?

The wedge-like design of the heel shoulders a lot of pressure, particularly when patients are in bed. It is a big load on a small area. The skin covering the calcaneus (heel) bone is only 3.8 mm thick. That is about the thickness of a cracker and only 0.46 mm of this skin is the epidermis. But the subcutaneous tissue isn’t much better. It is thick, firm and fibrous with little padding. All in all, it’s a recipe for disaster among those at risk.

Chronic conditions can also exacerbate the situation and the global pandemic didn’t help. According to the CDC, 34.2 million Americans have been diagnosed with Diabetes. That’s just over 1 in 10 people. That’s a lot. And of those individuals, it is estimated that between 15% and 25% of people with diabetes will develop foot ulcers. And that is just in a ‘normal’ year.
 
Treatment for diabetic-related foot injuries, such as heel offloading, casting, specialty dressings and at times debridement, typically require face-to-face interactions, and foot problems are the most common cause of hospital admissions for people living with diabetes. However, when COVID shut down the outpatient clinics and overloaded hospitals, patients were left without a lot of options. Less than 10% of patients with foot ulcers were able to visit a wound clinic amidst the lockdown. But the problems did not just go away!
 
Proper heel offloading is paramount in the prevention of heel ulcers and sometimes, pillows just won’t cut it. Lower extremity devices have come a long way and today do more than just cushion the foot. At the very least, the boot needs to safely and effectively offload the pressure on the patient’s heel. But it shouldn’t stop there.

Heel devices that address foot drop while effectively accommodating SCD devices warrant a closer look. Toss in protection and prevention from shear forces and lateral leg rotation and you’ve got a clear winner. Once the patients are safe and sound, the heel protector should also spread a little love to the clinicians as well. Boots that are easy to use and open-ended for quick assessments will surely reduce some of the stress and strain of a long shift. Learn more about heel protection solutions that have gone above and far beyond the pillow.

https://www.podiatrytoday.com/keys-addressing-posterior-heel-ulceration
https://www.sciencedirect.com/science/article/pii/S0268003320302126
https://www.o-wm.com/content/practice-recommendations-preventing-heel-pressure-ulcers
https://care.diabetesjournals.org/content/43/8/1704
https://care.diabetesjournals.org/content/43/10/e125.abstract
https://search.cdc.gov/search/index.html?query=diabetic+foot+ulcers&sitelimit=&utf8=%E2%9C%93&affiliate=cdc-main