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I sometimes have elderly patients complaining of a sore/tender area, usually on the heel margin or malleolus. I know the area concerned is a pressure sore waiting to happen. The patients are mobile during the day but always lie in the same position in bed all night.

Can anyone suggest inexpensive ways of relieving the pressure on these areas so that they do not ulcerate?

 

Hi
I sometimes come across this problem. There are lots of pressure relieving products on the market including mattresses and booties etc. Any disability shop will be able to help you if you have one in your area or a chat with your local community nurse will point you in the right direction.
Regards
Deborah

 

Whilst these dressings are indicated for granulating wounds, I have found Allevyn heel hydrocellular cups are great for protecting vulnerable areas around the heel margin. They are available on script, or from most pod suppliers;


http://wound.smith-nephew.com/uk/Product.asp?NodeId=561

Cheers,
Bel

 

Call me old fashioned, but many of my patients who are unable to turn over in bed and therefore have excessive pressure on the heels, have greatly benefitted from the use of a real sheepskin under their feet and heels. It is a long term solution , and synthetic sheepskin does not hAve the same benefit. Sheepskin heel cups are ok but tend to be too hot. In the uk Ikea have excellent sheepskins for about £23.

Regards
CM

 

Pressure at the malleolus? get them out of a boot and into a correctly fitted shoe.

A shoe should not touch the malleolus, it should be just below, if it is happening in a shoe the soft footbed may have collapsed allowing the client to sink further down into the shoe causing the contact, if so add a 4mm heel lift or better still replace the shoe.

Get the elderly fitted by a professional as feed back about what fits and what doesn't fit isn't always the best from these clients

 

These are pretty cheap, lightweight and comfortable. If memory serves, about £30 although it has been a few years.

http://www.vmmarketing.co.uk/06Heelift.html

Good luck

Robin

 

Sorry, I did not make it clear - the pressure is not from the foot wear but from them lying on their side in the same position all night, so the pressure is from their mattresses.

 

Thanks for the advice all. I did wonder about real sheepskin. Sadly we do not have an Ikea in this area. We have a huge distribution centre for them but no store. Go figure!

 

why not tell your patient to buy a decent pillow and place it under the calf whilst in bed, if the heel is elevated off the mattress no pressure damage can ensue

 

Ian's idea is perfect except for people who move around while sleeping. A cheap modification of the heel/malleolar float is to wrap same pillow circumferentially around the leg with the long axis of the pillow perpendicular to the tibial axis and either secure same with an Ace Wrap or have some seamstress affix a couple velcro closures to a pillow case. They can then roll all night and not lose the protection of the pillow.

With the usual legal disclaimer to not be a dumb butt and over tighten the wrap around the leg, pour hot coffee or molten lava over it, use it for target practice, etc.

 

Nice idea thanks - but I can see 2 problems. I think it would be very hot and, if the patient was moving around in the bed the initial problem would not occur. They lie in one position all night.

I used to suggest the pillow (or rolled up towel) under the calf but my sister in law, who is a nurse, said that could cause problems higher up the leg.

 

I wouldnt recommend a rolled up towel as the point of contact with the calf would be too narrow hence the concern.
Both myself and the Tissue viability team use pillows( I work in an acute unit) even when the patient is on a pressure relieving mattress. I accept there might be a problem if the patient is a fidget, but its cheap and usually readily available and the individual can see the heel being kept off the mattress.
If you have good access to equipment like the Repose, thats fine, but to buy privately that would cost I believe upwards of £80+. How much does a supportive pillow cost?