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Anesthesia Protocol for Heel Pressure Ulcer Debridement

O’Neill, Daniel K., MD; Tsui, Shek-man, BS; Ayello, Elizabeth A., PhD, RN, ACNS-BC, CWON, MAPWCA, FAAN; Cuff, Germaine, MPH, BSN, CCRP; Brem, Harold, MD

Advances in Skin & Wound Care: May 2012 - Volume 25 - Issue 5 - p 209–219
doi: 10.1097/01.ASW.0000414704.48514.fb

ABSTRACT Heel ulcers are clinically challenging. Limited subcutaneous tissue covering the calcaneus bone makes the heel vulnerable to pressure injury. Adequate debridement of fibrotic, infected, and necrotic tissue is essential for healing. The authors report a standardized anesthesia protocol using regional anesthesia with sedation rather than general anesthesia for heel debridement.

Daniel K. O’Neill, MD, is Assistant Professor of Anesthesiology, New York University School of Medicine.

Shek-man Tsui, BS, is Research Associate for NYU-NIH Summer Program, New York University Langone Medical Center.

Elizabeth A. Ayello, PhD, RN, ACNS-BC, CWON, MAPWCA, FAAN, is Faculty, Excelsior College School of Nursing, Albany, New York; Senior Advisor, The John A. Hartford Institute for Geriatric Nursing, New York University College of Nursing; and Clinical Editor, Advances in Skin & Wound Care.

Germaine Cuff, MPH, BSN, CCRP, is Program Director, Research, New York University Langone Medical Center.

Harold Brem, MD, is Chief, Division of Wound Healing and Regenerative Medicine, Winthrop University Hospital, Department of Surgery, Mineola, New York.

Dr O’Neill, Mr Tsui, Dr Ayello, and Dr Brem have disclosed they have no financial relationships related to this article.

Ms Cuff discloses that she is/was a recipient of grant/research funding from 3M.

Acknowledgment: This work was supported by NIH Grant RO1 LM008443-04.

Submitted May 18, 2011; accepted in revised form November 4, 2011.

© 2012 Lippincott Williams & Wilkins, Inc.