If the patient has been lying supine for a long time, they are most likely to develop bedsores on heels from lying down. The skin on the heels is particularly prone to deterioration, which poses a severe risk to ailing and immobile individuals.
It should be noted that there is only a thin layer of fat and skin covering the back portion of our heels, which makes it more susceptible to breakdown.
This is because their body weight (feet) is continuously putting pressure on the heels and lower legs, so the maximum pressure is concentrated on the lower legs. This results in poor blood flow to the skin and impairment of muscle tissues capable of absorbing stress.
Though bedsores on the heels are serious side-effects of various underlying diseases, it is a relief to know that there are techniques that can be adopted to prevent sores from developing.
First, let us understand what actually these bedsores on heels are. Bedsores, also known as pressure sores or decubitus ulcers, occur when there is excessive and prolonged pressure along the side of the bone, particularly in areas that are subjected to a substantial amount of pressure, the heels in this case. However, this condition can occur anywhere in the body. In the short term, if you are subjected to constant pressure on your muscles and bones, it can be uncomfortable and painful, and you are likely to develop bedsores within a few hours.
In this article, we shall be talking all about bedsores on heels. Let us find out more.
Symptoms of bedsores on heels
Bedsores on heels are common skin conditions that are characterized by a reddening of the skin which over time develops into an ulcer or sore that can be quite painful. It may penetrate deep into the bone or muscle, and as a result, it may cause serious damage to the underlying tissue.
There is an absolute necessity to take care of this condition; if it is left untreated, it will adversely affect your health and may even lead to cellulitis. It needs immediate treatment, or, if it develops into a severe problem, you should visit an experienced medical professional.
Causes of bedsores on heels
Bedsores on heels can be difficult to cure since they are caused by long-term continuous pressure that cannot be relieved. In this situation, the skin on the heels and underlying tissues are damaged due to a lack of mobility and adequate blood flow, resulting in damage. When you lie down for extended periods, the surface of the chair or bed can exert too much pressure on your heels due to the pressure generated by the surface.
A pressure sore can also be caused by friction between the heel’s skin and another surface. The condition is characterized by two layers of skin sliding over one another and can be avoided by moving in the opposite direction to avoid tissue damage.
Is there anything else that contributes to the development of pressure sores on heels? Well, moisture can also cause the skin on the heels to soften and may even result in pressure sores developing faster due to excessive moisture. The most common causes of bedsores on heels are:
- Nutritional deficiencies
- A low body mass index
- Inhaling tobacco
- Incapacity to move
- Irregular urination
- Having a dry skin
- Sensation impairment
- Use of corticosteroids
Furthermore, there are a number of conditions that can result in pressure sores appearing on heels, and some of them include:
- Anemia
- Infections
- Dementia
- Fractures
- Cancer malignancies
- Stroke
- Diabetes mellitus
- Edema
- Peripheral arterial disease
- Venous insufficiency
- Alcoholism
Early stages of bedsores on heels
Stage 1
In the initial stage of bedsores on heels, only the epidermis, which is the upper layer of the skin, is affected, which is the skin’s surface layer. As far as the skin is concerned, it remains intact during the process. Heel bedsores at Stage 1 usually exhibit a number of symptoms, including:
- Abnormal discoloration of the skin
- There may be a sensation of soreness on the heel
- Irritation and burning that is localized to heels
- The skin will be firmer and warmer than the surrounding tissues
- When the individual presses, the color of that heel skin will remain unchanged instead of turning white
Stage 2
When the pressure sores on heels reach the second stage, they tend to break from the top layer of skin. If this happens, then that will result in an open wound. The heel pressure sore will appear as a crater-like wound or a blister containing yellow or clear fluid at this stage. Symptoms related to Stage 2 heel pressure sores include –
- Pain
- Swelling or discoloration near the sore
- Sore may contain liquid or pus
Late stages: When to see a Doctor?
Stage 3
It is at this point that the bedsores on heels advance beyond the skin layer and reaches the layer of fat tissue. Secondary bacterial infection is highly likely to develop at this stage. This stage is characterized by symptoms such as –
- Odor
- Fever
- Pus or greenish fluid from the heel sores
- Dead tissue
Stage 4
At later stages, bedsores on heels become increasingly severe, due to the possibility that they may cause further damage to the fatty tissue and underlying layers such as ligaments, muscles, and tendons. In some cases, they may even extend to the bones. There are a number of symptoms associated with stage 4 pressure sores, including –
- Necrosis
- The heel skin area turns purple
- Pain
- Mushy or firm texture
When bedsores progress to these stages, they become so serious that the patient needs to consult a physician for the right course of treatment for bed sores on heels.
Treatment for bed sores on heels
You can prevent pressure sores in heels by constantly moving, avoiding constant pressure on the heel area, redistributing your body weight promoting blood flow. It is crucial to reposition your body at least every half hour if you are lying in bed or every 15 minutes if you are sitting on a chair. When you are unable to move, you can use pillows or foam wedges to assist you in shifting your weight.
Trying out some exercises (after checking with your doctor) that improve the range of motion, can promote better circulation, prevent contractures, and also maintain joint mobility, mass, and integrity. Depending on the degree of severity of the heel sores, there are some specific measures that you can use to lessen the pain and discomfort. Listed below are a few strategies that may be helpful:
- Initially, it is necessary to relieve pressure from the heel area. For that, specially designed pillows and foam pads can be used to support the legs and change the position of your body.
- You should ensure to gently wash the heel bedsores with water and mild soap. Whenever a dressing is applied to an open sore, the wound should be cleaned with a saline solution.
- It is also important to protect the wound to speed up the healing process. It may even be more effective to use an antimicrobial or hydrocolloid solution that contains alginic acid. But it is recommended that the person wear a protective dress before carrying out this procedure.
- Use antibacterial creams to protect the skin from further damage or vulnerability.
- You might also need to address the issue of incontinence; it will require the use of a cleanser, incontinence pads, or barrier cream.
- There may be dead tissue on the bedsores that need to be removed. This will help the heel bedsores patch up more quickly.
- You can use mattresses made of static foam or air mattresses that are helpful for relieving pressure on your body. Furthermore, some beds are equipped with pumps that can maintain a constant flow of air in the mattress, which is highly recommended by doctors.
That being said, if the bedsores develop into more severe wounds, you must seek professional healthcare services to treat bed sores on heels.
Summary
Pressure sores on heels can have a negative impact on the health and overall quality of life of the patient causing pain, prolonging stays at the hospital, and reducing their mobility. In some serious and worst cases, it might result in amputation of the area around the heels.
Using the specific techniques and devices designed for the management of bedsores can help reduce the effects, lessen friction, and shear on the heels of patients. This helps maintain the patient’s quality of life. However, treating, handling, and managing bedsores on heels must be carried out only after consulting with an authorized medical practitioner or caregiver. There are risks involved and it is important to first assess the condition of the sores and then decide how they should be treated.
The ideal situation is if bedsores on the heels are detected during the early stages. This is because, with timely and proper guidance and medication prescribed by doctors, it is possible to manage bedsores on heels and improve the chances of recovery.