Heel Pressure Ulcers (decubitus ulcers or bed sores)

What are heel pressure ulcers?

Heel pressure ulcers or sores are injuries to the skin and underlying tissue caused by prolonged pressure to the skin. The pressure to the skin limits the blood flow to the skin, which eventually leads to a break down of the skin and formation of a wound. 

How do you get pressure ulcers?

Heel pressure ulcers develop in people with very low mobility and sit or lay in one position without much movement. Other risk factors for developing heel ulcers are lack of feeling (neuropathy), poor blood flow, and poor nutrition. 

What are complications of developing heel ulcers?

Once a wound develops on the heel you can get a skin and soft tissue infection (cellulitis), bone infection (osteomyelitis), and this infection can lead to sepsis. In rare cases if you have a chronic heel ulcer it can develop into squamous cell carcinoma (marjolin ulcer)

How to prevent and treat heel ulcers?

People that have low mobility or who have a heel ulcer, the most important thing to do is offload the heel using pillows or an offloading device such as a prevalon boot. If there is an infection then antibiotics will be given, if there is a wound it needs to treated with proper local wound care, and  a bone infection will typically require surgery and IV antibiotics. It is important to adjust the patient position from time to time and keep the skin clean and dry. Other common areas to develop pressure ulcers besides the heel is tailbone, shoulder blades, back of arms and legs, back or side of head.