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Peripheral Artery Disease IV: Nursing Management

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Related Experiment Video

Updated: Apr 15, 2026

Fabrication of Compressed Hosiery and Measurement of its Pressure Characteristic Exerted on the Lower Limbs
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Pressure-ulcer reduction using low-friction fabric bootees.

Deborah Gleeson1

  • 1Lead Nurse Service Manager, Tissue Viability, St Helens and Knowsley Teaching Hospitals NHS Trust, Whiston Hospital, Merseyside.

British Journal of Nursing (Mark Allen Publishing)
|March 28, 2015
PubMed
Summary

Low-friction fabric bootees significantly reduced heel pressure ulcers by 78% in a hospital setting. This intervention contributed to achieving zero harm targets and provided cost benefits to the NHS.

Keywords:
Friction and shearHeelPressure ulcerProduct evaluation

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Area of Science:

  • Healthcare quality improvement
  • Patient safety research
  • Wound prevention strategies

Background:

  • Hospital-acquired pressure ulcers remain a challenge despite existing management measures.
  • Grade 2 pressure ulcers, particularly on the heel, are often linked to friction and shear.
  • Targeting heel pressure ulcers is crucial for reducing overall incidence.

Purpose of the Study:

  • To evaluate the effectiveness of low-friction fabric bootees in preventing heel pressure ulcers.
  • To assess the impact of this intervention on overall pressure ulcer rates.
  • To determine the cost-effectiveness of using low-friction bootees.

Main Methods:

  • Implementation of low-friction fabric bootees (Parafricta®) for at-risk patients between 2012 and 2013.
  • Monitoring of pressure ulcer incidence, with a specific focus on grade 2 heel ulcers.
  • Analysis of changes in the ratio of heel to other grade 2 pressure ulcers.

Main Results:

  • A 78% decline in heel pressure ulcers was observed over the 2-year study period.
  • A significant reduction in the ratio of heel to all other grade 2 pressure ulcers (from 0.67 to 0.24).
  • Implied net cost savings to the NHS based on avoided heel pressure ulcers.

Conclusions:

  • Routine use of low-friction fabric bootees significantly contributed to reducing hospital-acquired pressure ulcers, especially on the heel.
  • The intervention supported the achievement of zero harm targets.
  • The use of low-friction bootees demonstrated substantial cost benefits for the NHS.