Title: Anatomical location of injury in Stage I and Stage II heel pressure injuries : a pilot study
Abstract: Human feet, and heels in particular, are well adapted for movement but are at great risk of pressure injury when people are immobilised. Heels are the second most common anatomical location of pressure injuries. Whilst there are aids available to minimise potential for injury, these devices have been developed in the absence of precise knowledge of the exact location of pressure injury development in this highly specialised site. The primary aim of this pilot study was to explore the anatomical locations of Stage I and Stage II pressure injury foci on the heels of adult inpatients. A secondary aim was to test data collection processes to inform development of a larger study. A prospective, descriptive design was utilised at a tertiary hospital with a convenience sample of inpatients with Stages I or II injury on either heel. A wound management system (VISITRAKTM) was used to measure wound dimensions producing a visible record. Seven patients were recruited with nine pressure injuries in total. When aggregated, the anatomical location of heel pressure injuries was primarily around the midline close to the junction of the calcaneus and sole of the foot. Aggregated data suggest that the left heel had a greater area of injury. We have described the exact location of Stages I and II pressure injuries in a small sample of hospitalised patients for the first time. These findings should be replicated in other patient populations to facilitate development of better devices for prevention of pressure injuries at this vulnerable anatomical location. What is already known about the topic: Pressure injuries are a preventable cause of patient morbidity. Heel pressure injuries are common and, despite extensive research, their prevention and management remains a major challenge in health care settings. What this paper adds: This novel research reports a method to describe the exact anatomical location of heel pressure injuries and the natural fall of the foot in supine lying, described using the angle of the long axis of the foot from the vertical. It adds to existing knowledge to guide clinician decision-making in the prevention and management of pressure injuries.
Publication Year: 2012
Publication Date: 2012-09-01
Language: en
Type: article
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