Effects of compression and type of bed surface on the microcirculation of the heel

Abstract

The results indicate that the heel microcirculation is vulnerable to compression. The low air-loss system maintained the IP sufficiently low to prevent complete cessation of the heel microcirculation.

Lesson of the week: Postoperative pressure sores after epidural anaesthesia

“…The comparison of reflected light between the static skin and moving blood gives a qualitative estimate of blood flow. This technique shows a great reduction in blood flow in the skin when a patient lies on a conventional NHS bed 6. Patients at increased risk of pressure sores should therefore be nursed on pressure relieving mattresses such as the large celled ripple bed 7 8; none of our patients were nursed on such mattresses.…”

Physiology and prevention of heel ulcers: The state of science

“…Most of the support surfaces had exceeded the acceptable capillary closing pressure, 35 or had no significant reduction [36][37][38] on heel pressure. Heel interface pressure remains lower in pressure 36,39,40 reduction/relieving surfaces than in conventional hospital mattresses.…”

Effects of Different Cyclic Pressurization and Relief Patterns on Heel Skin Blood Perfusion

“…These detrimental blood flow changes affect skin breakdown in multiple ways, [7][8] with the greatest frequency at sites of bony prominences. The heel is particularly prone to such effects, 9 in part because of its relatively lower resting blood perfusion level, 10 higher amounts of surface pressure when under load, [11][12][13][14] and the possibility of compromised local blood flow if lower-extremity arterial disease is present. 10 Skin breakdown processes are affected by decreases in local blood flow during heel loading 10 and by flow recovery features after unloading.…”

“…The heel is particularly prone to such effects, 9 in part because of its relatively lower resting blood perfusion level, 10 higher amounts of surface pressure when under load, [11][12][13][14] and the possibility of compromised local blood flow if lower-extremity arterial disease is present. 10 Skin breakdown processes are affected by decreases in local blood flow during heel loading 10 and by flow recovery features after unloading. [15][16][17] Practical strategies that would efficiently minimize the detrimental effects of pressure have remained elusive.…”

“…A basis for a potentially effective management strategy has evolved from previous work. [10][11][15][16][17] The most directly relevant finding 17 was that when heels are pressure loaded for different durations with the same pressure or with different pressures for the same duration, a load-and duration-dependent blood flow hyperemia results when pressure is relieved.…”