Pressure ulceration of the heel: prevalence, complexities and management
Atkin, Leanne Chaplin, Emma Dingley, Jess Phillips, Kelly Robinson, Hollie
Atkin, Leanne
Chaplin, Emma
Dingley, Jess
Phillips, Kelly
Robinson, Hollie
Abstract
Heel pressure ulceration remains a significant and largely preventable cause of morbidity, yet it continues to pose complex clinical challenges. The heel's unique anatomical structure, limited soft-tissue padding and relatively poor vascular supply increase vulnerability to pressure, shear and friction, particularly among older adults and individuals with diabetes or peripheral arterial disease. This article synthesises the evidence surrounding the prevalence, risk factors and pathophysiology of heel pressure ulcers, highlighting their propensity for delayed healing, infection and limb-threatening complications. Despite their frequency and severity, current national guidelines provide limited heel-specific recommendations, resulting in variation in practice. The article discusses the importance of comprehensive risk assessment, early vascular evaluation, and implementation of evidence-based prevention strategies such as effective offloading. Key principles of local wound management, including debridement, infection control and appropriate dressing selection are outlined. By improving recognition of heel-specific risk and promoting consistent, multidisciplinary approaches, clinicians can reduce avoidable harm, enhance healing outcomes and support improved quality of life for patients with heel pressure ulceration.
MIDER Authors
Affiliations
Mid Yorkshire NHS Teaching Trust; University of Huddersfield; University Hospitals of Derby and Burton NHS Foundation Trust; Manchester University NHS Foundation Trust; Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust; South Warwickshire University NHS Foundation Trust
Date
2026-02-04
Type
Article
Subject
Collections
Citation
Atkin L, Chaplin E, Dingley J, Phillips K, Robinson H. Pressure ulceration of the heel: prevalence, complexities and management. Br J Nurs. 2026 Feb 5;35(3):S10-S15. doi: 10.12968/bjon.2025.0369. Epub 2026 Feb 4.