by Laurie Swezey RN, BSN, CWOCN, FACCWS
Heels are particularly vulnerable to skin breakdown. The posterior heel is only covered by a thin layer of skin and fat, and that makes breakdown a very real risk. When patients lie supine, all of the pressure of their lower legs and feet rest on the heels, which have relatively poor skin perfusion and a paucity of muscle tissue to absorb stress.
Prevalence rates for heel pressure ulcers vary, but have been estimated to be as high as 25% across a mixture of continuing care and acute care settings. Heel ulcers represent approximately one third of pressure ulcers acquired, resulting in increased morbidity and mortality. In some cases, heel pressure ulcers can lead to amputation of the affected limb.