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Physiology and Prevention of Heel Ulcers: The State of Science

Wong, Vivian K. RN, MSN, CNS, CWCN, CWON; Stotts, Nancy A. RN, EdD, FAAN

Section Editor(s): Pieper, Barbara PhD, RN, CS, CWOCN, FAAN

Journal of Wound, Ostomy and Continence Nursing: July 2003 - Volume 30 - Issue 4 - p 191–198
WOUND CARE

The prevalence of heel ulcers across settings is high and is increasing. Prevention of ulcers requires knowledge of their etiology and the scientific basis for preventive care. The interaction between external pressure and the heel vasculature is central to the prevention of heel ulcers. This article focuses on the prevention of heel pressure ulcers. The physiology of heel tissue perfusion, the effect of external pressure on heel perfusion, as well as what is known about strategies to reduce external pressure and approaches to improve heel skin blood flow will be discussed. It is only through understanding of the physiology of heel tissue perfusion and its relation to external pressure that effective preventive measures to reduce heel skin breakdown can be adapted in clinical practice.

The physiology of heel tissue perfusion, the effect of external pressure on heel perfusion, as well as what is known about strategies to reduce external pressure and approaches to improve heel skin blood flow are considered, pursuant to providing effective preventive measures to reduce heel skin breakdown in clinical practice.

Vivian K. Wong, RN, MSN, CNS, CWCN, CWON, is a Doctoral Student in Nursing, University of California-San Francisco, San Francisco, California.

Nancy A. Stotts, RN, EdD, FAAN, is Professor of Nursing and John A. Hartford Scholar, University of California-San Francisco, San Francisco, California.

Reprint requests: Vivian Wong, 41791 Denise St, Fremont, CA 94539; e-mail: vwongk@yahoo.com.

Copyright © 2003 by the Wound, Ostomy and Continence Nurses Society