Outcomes from a Heel Pressure Ulcer Prevention Program

Note: The Original PI was Joseph Warren, MAJ, USAR.

This study compared the effects of three pressure-reduction devices on preventing heel ulcers for "moderate-to-high-risk" patients in a randomized, prospective trial. Analyses examined cost-effectiveness and relationships between factors that predispose patients to pressure ulcers.

This study compared the effects of three pressure-reduction devices on preventing heel ulcers for "moderate-to-high-risk" patients in a randomized, prospective trial. Analyses examined cost-effectiveness and relationships between factors that predispose patients to pressure ulcers.

Of enrolled subjects, 69% were ICU patients. In 240 patients, 12 pressure ulcers developed (incidence = 5.5%). Three occurred in 77 subjects (3.9%) wearing polyester fleece heel protectors, 4 developed in 87 subjects (4.6%) wearing the foam foot prop positioner, and 5 occurred in 76 subjects (6.6%) wearing the air-filled waffle boots. No statistically significant differences between the devices were found. Risk for developing a pressure ulcer was 2 times higher in smokers and those with existing pressure ulcers.

This study confirms that good nursing care is the most important factor in preventing pressure ulcers. Subjects did not always wear the devices, largely because they were removed for nursing/medical procedures and not replaced. Also, the higher the subjects' level of consciousness, the less likely they were to wear the boot. The finding that smoking increases risk can serve as a cue to nursing staff to closely monitor the skin for signs of breakdown in patients with a history of smoking.

Final report is available on NTRL: https://ntrl.ntis.gov/NTRL/dashboard/searchResults/titleDetail/PB2007107...