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Boots To Prevent Pressure Ulcers

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Prevalon Heel Protectors Reducing Heel Pressure Ulcer Risk


Multiple guidelines recommend the use of a heel protection device that completely offloads the heel to help prevent the development of heel pressure ulcers. Prevalon® Heel Protectors are the number one brand of heel protection. They offer continuous heel offloading to protect your patients heels.

Choose the optimal heel protector

Experts suggest the optimal heel protector should go beyond offloading the heel. In order to effectively protect the foot and lower limb, a heel protector should prevent foot drop and use an anti-rotation wedge to keep the foot in a neutral position to protect the peroneal nerve. Prevalon® Heel Protectors are available with a contracture strap to help prevent the foot from dropping and an anti-rotation wedge to keep the limb from externally rotating. They also feature a unique dermasuede interior designed to gently grip the limb so it remains fully offloaded, even when the patient moves.

Proven prevention results and cost savings

A study published in JWOCN demonstrated a 100% prevention of both heel pressure ulcers and plantar flexion contracture over a seven month period when using Prevalon® Heel Protectors.

In Hospital Pressure Prevention Products Devices And Aids

There are several in hospital pressure prevention devices and aids, as noted below.

Therapeutic Linens

These textiles and bed linens are FDA cleared and are designed to control friction and shear factors.

Surgical Surfaces which may include Foam, Air or Combination

These surgical surfaces are made for individuals who are at a very high risk of getting pressure ulcers or patients who are undergoing a longer surgical procedure. They assist in redistributing pressure while undergoing a surgical procedure and recovery.

Powered Covers

These are electric powered covers that are placed across standard mattresses to promote microclimate.

Alternative Pressure

Air bladders and individual calls inflate alternatively to redirect pressure. There is still a need for the patient to be repositioned or turned on these mattresses.

Static Flotation

It uses water, air, gel or foam components to shift pressure from areas that are valuable.

Air Fluidized

Filtered air circulation through the silicon covered ceramic beads develops a patient fluid or floating on the surface.

Low Air Loss

They promote microclimate by continuously forcing the circulation of air through a tiny pinhole in the mattress.

Ideal For Surgery Recovery Lower Limbs

When I had surgery on my femur i noticed that within a day that my heavy stagnant leg was starting to give me pressure pain on my heel. The hospital cotton heel protector cushion was uncomfortable, lifted my foot up high so it over extended my knee, and I had to ask staff to remove and reinstall the boot when i needed to use the bathroom. On top of this it didnt relief my pain. Then I switched to the Maxxcare heelpro. WHAT A DIFFERENCE. It felt like putting my foot on a cloud. It felt secure and stable, didnt overextend my knee, I could glide my foot with boot easily over the sheets to position, AND THE BEST PART I didnt have to ask for assistance to remove the boot when I left my bed. I could just keep the boot on and walk small distances. All hospitals should have these!

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Types Of Pressure Injury Prevention Devices And Aids

Pressure prevention devices are classified as follows.

1. Static Devices

These devices include gel, water, foam, and mattress overlays or air mattress. Form or air or gel mattress may be used so also wages. Pillows and chair cushions are not excluded, so also are pads that are used to absorb the patients wetness and to help keep their skin dry.

Tip: Here is the Guide for Choosing Best Cushion for a Wheelchair.

2. Dynamic Devices

These devices include alternating pressure devices, air fluidized and low-air loss surfaces. They use the help of a power source in redistributing localized pressure. These pressure reducing surfaces reduce sore incidence with 60% when compared to standard hospital mattresses.

Generally, dynamic devices are more expensive and noisy than static devices. Their surfaces can be helpful when a patient is not able to independently change his or her position or when a patient experiences a poor healing procedure.

Now, lets look into popular in-hospital and in-home pressure ulcer relieving techniques.

Heel And Elbow Protector Applications And Uses


Bed Sore Treatment

Material options for pressure relief include foam and synthetic sheepskin construction to achieve softness with a boot-like fit. Both options offer extra padding and comfort to protect bony prominences. These materials naturally contour to the body for complete protection. Some protector options are universal to apply to either the heel or elbow and fastens with a hook and loop strap. Sheepskin is washable for multiple uses.

Another option for pressure relief is to use a free-standing offloading device like the HeelZup. The patient props up the feet onto a high-density foam platform to relieve pressure from the heels. This product is free-standing and doesn’t require direct application to the foot or elbow, which may be helpful to patients with wounds.


Protection from Shear and Friction

Sitting for a long period can cause skin breakdown. Repositioning the arms or feet adds friction to the vulnerable skin. Protection is simple and easy with heel and elbow pads. The stretchable woven fabric places a barrier to reduce downward pressure and friction.


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Predictors For Heel Pressure Ulcer

No variables assessed in the ambulance or at the ED predicted heel pressure ulcer during the hospital stay. However, at Day 1 at the ward, statistically significant differences were identified between patients who later developed heel pressure ulcer and those who did not, regarding the MNS sub-categories , physical activity , mobility , and incontinence ), as well as total risk score . Also, at Day 1 at the ward, significantly fewer patients with a heel pressure ulcer or who developed heel pressure ulcer later during their hospital stay received an oral nutritional supplement compared to those with no heel pressure ulcer . Statistically significant differences could not be noted regarding other preventive actions, such as using a pressure-reducing mattress and a turning schedule.

Proven Results: Prevention And Treatment From The #1 Brand Of Heel Protection1

Prevalon brings you more proven clinical studies and financial outcomes than any other brand.Heel Ulcer Reduction

  • A study published in JWOCN found the use of Prevalon and a heel ulcer prevention protocol led to a 95% decrease in heel pressure ulcers.2
  • Another study published in JWOCN demonstrated a 100% prevention of both heel pressure ulcers and plantar flexion contracture over a seven month period when using the heel protector device.3
  • In one study, implementation of a heel pressure ulcer prevention protocol that included Prevalon Heel Protector resulted in a 28% decrease in facility- acquired heel pressure ulcers over a one-year period. Continued use of the Prevalon Heel Protector over four years, coupled with in-depth education, continuous monitoring of compliance, and continual reporting of outcomes to ensure accountability, resulted in a cumulative 72% decrease in heel pressure ulcers.4
REFERENCES: 1. GHX Trend Report ,4th Quarter, 2011 Hospital Annualized markets based on last 4 quarters data. 2. Lyman V, Successful Heel Pressure Ulcer Prevention Program in a Long-Term Care Setting. J Wound Ostomy Continence Nurs. 2009 Nov-Dec 36:616-21. 3. Meyers T, Preventing Heel Pressure Ulcers and Plantar Flexion Contractures in High Risk Sedated Patients. J Wound Ostomy Continence Nurs. 2010 Jul-Aug 37:372-8. 4. Hanna-Bull D, Four Years of Heel Pressure Ulcer Prevention. Poster presented at the 19th Annual CAWC Conference November 7-10, 2013, Vancouver, Canada.

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Evaluation Of The Product

The evaluation of the Repose foot/heel protectors was carried out over a three-month period. Inclusion criteria selected patients who:

– Had sustained a fractured neck or shaft of femur

– Were anticipated to be on bed-rest for 24 hours or more and were over 70 years old

– Had a spinal injury .

The limb was excluded from the study, if on admission:

– The heel had a ulcer classified as stage 3 or greater

– The leg was in a plaster of Paris cast

– Specific treatment regimens prescribed by the patientâs consultant would not allow Repose boots to be worn .

The evaluation took the following format: patients were fitted with a pair of Repose boots on admission to the ward. Heels were reviewed daily for signs of pressure or friction damage and recorded on the data sheet. If the patient developed a stage 2 ulcer during the study the use of the boots was discontinued and preventative management was reassessed.

If the patient had to be taken out of the study for any other reason this was documented on the data form. Otherwise the Repose boots were worn at all times when the patient was on bed rest until discharge from the ward or transfer back to referring hospital.

Why Heelift Boots Create A Cooler Drier Microclimate

How to reduce pressure on heels with Prevalon Heel Protector 27400

There are a few features of Heelift® Brand Boots that help create the desired cooler, drier microclimate that prevents pressure ulcer development. As the above cut-away shows, HEELIFT® completely offloads the heel, allowing heat and moisture to escape so long as the patient is turned regularly. Additionally, the ventilation holes found in the HEELIFT® AFO, HEELIFT® Glide, and HEELIFT® Classic further help the flow of heat and moisture.

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Prevention Of Heel Pressure Ulcers In An Orthopaedic Unit

18 June, 2002

VOL: 98, ISSUE: 25, PAGE NO: 53

Anne Wilson, RGN, BSc, is tissue viability nurse, Royal Alexandra Hospital, Paisley

The development of hospital-acquired pressure ulcers on the heel is a well-acknowledged problem . In fact, after the sacrum the heels are the second most common anatomical site for the development of ulcers , and their incidence has increased steadily over the past few decades .

Although tissue breakdown is a complex multifactorial process, the focus with pressure ulcer development in the heels is on extrinsic factors such as pressure, shear and friction, with the most plausible explanation being the failure to relieve pressure. While many advances, such as pressure-relieving mattresses and beds, have greatly reduced the incidence of sacral ulcers . Krasner recognised that, even with pressure reduction, most support surfaces do not adequately relieve heel pressure.

Pressure ulcers may form when heel pressure on the mattress exceeds the capillary closing pressure and the heel position is not changed frequently enough . The heel is at increased risk of ulceration as it has a relatively low resting blood perfusion level if subjected to lower pressures than 32mmHg .

Cheney suggests this problem is compounded by orthopaedic surgical procedures requiring long periods in the operating room and in recuperation. To prevent the development of heel ulcers, therefore, predisposing factors must be identified, minimised and/or relieved .

Preventing The Development Of Heel Pressure Ulcers

Patricia Davies Senior lecturer, Course leader tissue viability pathway and modules, Birmingham City University, Birmingham, England

Why you should read this article:

  • » To improve your knowledge of the causes and risk factors associated with heel pressure ulcer development

  • » To understand the various elements of an effective risk assessment for pressure ulcers

  • » To provide effective patient care in the prevention of pressure ulcers, based on the latest clinical evidence and research

The heel is a common site for pressure ulcer development, particularly in people who are supine or semi-recumbent because of immobility. There is little protective subcutaneous tissue and no muscle or fascia within the heel, which means that it is vulnerable to pressure, friction and shear forces. Heel pressure ulceration remains a clinical challenge for nurses and the wider healthcare team, as well as a cause of pain and physical debilitation for the patient. This article examines the risk factors for heel pressure ulceration, and details patient assessment and specific measures that can be undertaken to prevent the development of heel pressure ulcers.

Nursing Standard. doi: 10.7748/ns.2018.e11294

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Why Is Microclimate Important

In a recent study published in the Journal of Tissue Viability, Amit Gefen PhD. Dept. of Biomedical Engineering wrote, There is increasing evidence that thermodynamic conditions within and around skin tissue strongly influence the susceptibility of skin to SPUs Successful pressure ulcer prevention depends upon a complex balance between two sets of parameters the external loads applied to the skin and soft tissues, and the intrinsic ability of the skin and soft tissues to withstand prolonged or excessive loading. If the intrinsic resilience of the skin and soft tissues deteriorates, pressure damage is more likely to occur. Hence, a full understanding of a patients conditions, and immediate environment, including anything that may cause the patients skin to increase in temperature or moisture should be considered.

What Is A Pressure Ulcer?

A pressure ulcer is an injury to the skin as a result of sustained pressure applied to the skin over time . The pressure results in reduced blood flow and eventually causes skin breakdown and the development of an open wound. If the conditions leading to the sore are not rapidly corrected, the localized skin damage may spread to deeper tissue layers, affecting muscle, tendon, and bone. If not adequately treated, open ulcers can become a source of pain, disability, and infection.

Why is Prevention Important?

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At Home And Aged Care Pressure Ulcer Prevention Products And Devices

Pressure Ulcer Prevention Boot

Here are the aids typically used at homes as a long-term pressure ulcer care.

Pressure Relieving Mattresses

These pressure relieving mattresses are used for individuals who are at high risk of getting pressure sores.

Ø There are different types of mattresses such as

Ø gel and water mattresses,

Ø innerspring mattresses,

Tip: Using a wheelchair? Then a Roho Cushion or a Star Cushion is a must.

Heel-Elevating Boots

Heel-elevating boots help to suspend the patients feet in mid-air, as the feet are the areas commonly affected by the pressure ulcers in the elderly.

These heel elevating boots help to redistribute pressure to the lower leg to avoid heel pressure sores. These devices gently cushion and cradle the foot, ankle and lower leg to minimize the risk of pressure points and skin friction.

Tip: Rooke Vascular Boots can help you prevent pressure injuries.

Pressure Offloading

Pressure off-loaders such as Darco Offloading Shoes and Insoles can help you prevent injuries in the feet.

Skincare Products

Many skin care products can be used to help protect and prevent the skin from getting pressure.

I have noted the main types below.

i. Antimicrobial Skin Cleansers

These products help to remove bacteria and combat infections around broken skin. Antimicrobial cleansers destroy such pathogens, which otherwise could reinfect and result in deadly complications of pressure ulcers.

ii. Cleansing Body Lotion
iii. Skin Protectants

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Three Heel Protectors That Effectively Grip The Limb

Available from Iskus Health in

  • United Kingdom
  • Republic of Ireland

The Prevalon Heel Protector was specifically designed to address the problem of patient movement and its negative effect on heel offloading. Prevalons unique dermasuede fabric interior gently grips the limb so it remains fully offloaded, even when the patient is moving.

Our specialized fabric and coating creates maximum grip control with the texture of fine velvet. This soft fabric contours to and cradles the leg, calf, ankle and foot to help prevent them from rotating within the boot or sliding out of the bootmaintaining effective heel offloading.

Dermasuede fabric holds the limb securely in place while preserving patient comfort. Its also a breathable material, so the limb remains cool while inside the heel protector.

Pressure Ulcer Treatment Products

There is numerous kind of products on the market to prevent and treat pressure ulcer, but they may not all work perfectly for everybody. The symptom and severity level of the sores determine the right pressure sore treatment product.

There is some manufacturer that offers pressure ulcer and bedsore management which include the following.


Posey manufactures and distributes quality and safe products such as foot elevators, heel pillows, heel guards, elbow protectors, memory foam cushions and many more.


Med-Line produces and distributes more than 350,000 products which include pressure ulcer prevention products and supplies.

The Med-Line innovative products can be seen in hospitals, surgery centers, extended-care facilities, home care dealers, physician offices, retail outlets, and home health agencies.

Their products for pressure ulcer treatment include elbow protectors, heel protectors, convoluted foam boots and many others.

Briggs Health Care

This company serves over 50,000 people in the acute care, physician, senior care, and retail markets. They distribute more than 10,000 products which include products for pressure sores treatment too.

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Background To The Study

A number of elderly patients being transferred from the Royal Alexandra Hospitalâs orthopaedic unit postoperatively to the rehabilitation wards had developed nosocomial pressure ulcers on their heels. This resulted in increased time and money being spent on dressing changes, while problems with mobilisation were hindering rehabilitation.

Heel pressure ulcers increase morbidity and costs and can cause immeasurable pain and distress to the patient.

To ascertain the extent of the problem a three-month report on the incidence of pressure ulcers was compiled. The overall incidence was reported at 5.6% of the total number of admissions 47% of all ulcers were on the heel – a total of 29 heel ulcers. When these figures were broken down, 18 of these ulcers had been acquired while in the orthopaedic unit. It was also noted that 13 ulcers present on admission to the unit had been inherited from other hospital wards or care facilities.

All patients reported with nosocomial heel ulcers were assessed on admission or during the three-month study period as having a high or a very high Waterlow Score. All but one hospital-acquired ulcer occurred in the two larger 30-bed wards that admitted all orthopaedic emergencies, the majority of which are elderly patients with fractured neck of femur.

Why Is Preventing Pressure Sore Essential

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Pressure ulcers are common in-home care and hospitals settings. A survey conducted recently revealed that about 26.7% of patients in the home care and hospitals had pressure sores.

Such ulcers do not heal very fast, and it is always tough to protect them from being infected.

Once they become open sores and infected, it will be very problematic for them to heal. The increased rate of pressure ulcer tallies with notable time and money spent on treatment and care.

In America, the yearly estimated cost of pressure ulcer treatment is about 11.6 billion U.S. dollars, this present pressure ulcer as one of the most expensive medical conditions. In order to improve health conditions and reduce costs, health care personals and nurses need to take a proactive measure focused on preventing pressure ulcers.

Now, lets look at pressure ulcer prevention interventions and strategies you can consider regardless of the setting, from a hospital to in-home care settings.

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