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Gefen A
British journal of nursing (Mark Allen Publishing). Date of publication 2017 Nov 8;volume 26(Sup20):S62-S74.
1. Br J Nurs. 2017 Nov 8;26(Sup20):S62-S74. doi: 10.12968/bjon.2017.26.Sup20.S62. Why is the heel particularly vulnerable to pressure ulcers? Gefen A(1). Author information: (1)Professor in Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Israel. In this article, the vulnerability of the soft tissues of the heel to pressure ulcers (injuries) is explained from a biomechanical engineering perspective, and emerging technologies for protecting the heel, particularly low-friction garments, are reviewed. Sustained deformations in the soft tissue of the weight-bearing posterior heel cause progressive cell and tissue damage due to loss of homeostasis in the cells, as the cytoskeleton and plasma membranes of the affected cells lose integrity and functionality. This deformation damage onsets and evolves rapidly when there is no relief of the tissue distortion (e.g. in supine motionless lying). Hence, prevention should be timely and be applied across all patient populations that are at risk. In particular there is a need to protect tissues from the action of frictional forces that are shearing not only the skin but also the deep tissue structures of the heel. The internal anatomy and physiology of the posterior heel, the common hospital conditions (lying supine, head of the bed elevated) and medical conditions involving neuropathy and perfusion impairments may impose specific risk for heel (pressure) ulcers. There is growing evidence that low-friction-fabric garments may provide added benefits in preventing heel ulcers when used in addition to standard clinical and technology-supported pressure ulcer prevention strategies, as the low-friction fabric structures absorb frictional forces before these are able to considerably distort the susceptible heel tissues. DOI: 10.12968/bjon.2017.26.Sup20.S62 PMID: 29120686
Appears in following Topics:
Pressure Ulcers/Injuries - Introduction and Assessment
Pressure Ulcers/Injuries - Treatment