Pressure-relieving devices for treating heel pressure ulcers

Pressure ulcers are areas of localised damage to the skin and underlying tissue caused by pressure or shear. Pressure redistribution devices are used as part of the treatment to reduce the pressure on the ulcer. The anatomy of the heel and the susceptibility of the foot to vascular disease mean that pressure ulcers located there require a particular approach to pressure relief.

To determine the effects of pressure-relieving interventions for treating pressure ulcers on the heel.

We searched the Cochrane Wounds Group Specialised Register (searched 25 March 2011); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 1); Ovid MEDLINE (1948 to March Week 3 2011); Ovid EMBASE (1980 to 2011 Week 12);Ovid MEDLINE (In-Process & Other Non-Indexed Citations March 29, 2011); and EBSCO CINAHL (1982 to 25 March 2011). We applied no language or publication date restrictions.

We included randomised controlled trials (RCTs) that compared the effects of pressure-relieving devices on the healing of pressure ulcers of the heel. Participants were treated in any care setting. Interventions were any pressure-relieving devices including mattresses and specific heel devices.

Both review authors independently reviewed titles and abstracts and selected studies for inclusion. Both review authors independently extracted data and assessed studies for risk of bias.

One study met the inclusion criteria. This study (141 participants) compared two mattress systems however losses to follow up were too great to permit reliable conclusions.

This review identified one small study at moderate to high risk of bias which provided no evidence to inform practice. More research is needed.