The heels are a particularly vulnerable part of the foot, prone to skin breakdown and dryness. Part of that is because the posterior heel is composed of a thin layer of fat and skin. Breakdown is made worse because people stand on their feet, putting pressure on the area, as well as the lower legs, upper legs, and spine. While those areas are splitting pressure with the feet, the feet absorb most of the stress due to poor skin perfusion and a lack of muscle tissue. Heel ulcers are a prevalent type of ulcer, especially found in continuing care and acute care settings, affecting approximately 25% of patients. They result in increased morbidity and can even lead to amputation.
What are the Risk Factors?
When it comes to heel ulcers, there are quite a few risk factors. The list below can be applied to any type of pressure ulcer, including heel ulcers. These factors further increase the risk of morbidity and amputation.
- Old age
- Abnormal circulation
- Poor nutrition
- Poor immunity
- Sensory deficiency
- Hearing deficiency
- Various comorbidities, including diabetes
- Peripheral vascular disease
- Fractures, including hip fracture
How Can You Tell if You Have a Heel Pressure Ulcer?
The clinical presentation of a heel pressure ulcer changes as the ulcer progresses.
- At first, the ulcer has the following presentation: tenderness, discoloration of the skin and changes in skin temperature (these will all progress over time if the ulcer isn’t treated.)
- If the ulcer is affecting the deep tissue, you’ll see dark coloring around the wound that presents as either purple or reddish-purple. Also, as the ulcer progresses, the tissue will be either warmer or cooler to the touch.
- Another possible scenario is that the skin around the ulcer develops blisters. Blisters always form in relation to a preexisting injury or condition, such as burns.
- If the tissue deteriorates further, it may actually lead to an open wound.
Preventing Heel Ulcers
Here are some suggestions for how to prevent heel pressure ulcers from developing. Because, after all, the best defense is a good offense. This is especially true for pressure ulcers.
- Wash everyday
- Take pressure off of the feet and heels
- Keep an eye on wounds
Treatment of Existing Heel Ulcers
If the wound has already formed, a good treatment plan is of the utmost importance.
- Stay Elevated – Use pillows to offload heel pressure. Put them lengthwise underneath the calf to maintain the proper position.
- Try An Offloading Device – There are many different offloading devices available to help with heel ulcers, including sheepskin, bunny boots, and splints. The greatest thing about these devices is that, unlike pillows, these will stay in place for long periods of time, including when the patient is in bed.
Contact Wound Care OC for wound treatment in Orange County, CA
Dr. Faried Banimahd is a board-certified physician specializing in emergency medicine, wound care, and pain management. Our team will work with you to create an individualized treatment plan that meets your needs and unique conditions. Our clinic includes highly trained and experienced physicians, registered nurses, and certified medical staff who work together to provide you with the highest standards of wound care treatments.