Another heel wound

[Rook98006]

Have a small wound on my heel...about the size of a pee. It appears to be shallow. Treated it with Iodosorb for a couple days and then Bacitracine for a day. Then covered it using a hydrocolloid bandage without any ointment or dressing.

My questions is about compression socks....should they be avoided or is it okay to wear over the wounded heel? Should I put some type of ointment on before covering with the bandage? The package says it good for multi day use...how often should this type of bandage be changed?

While in the bandaid isle I also see silicon tape...advertised to help heal scars. Does this work or just a waste of time?

Thxs

[crags]

In my opinion, I would say stop the compression socks for a good long while until you have substantial coverage over the area. I would think any type of downward pressure from the sock would inhibit the delicate new skin trying to push his way upward from below and regranulate the wound. Keep it clean, keep all pressure off it, I would keep it moist until it starts substantially regranulating. I would use the moist wound cream, followed by hydrocolloid gel sheet cut to size, followed by a nonstick Telfa pad held in place by gentle silk or paper tape, as you don't want further skin breakdown by tape that is too tenacious to remove.

Also, be damn sure your footwear is not inhibiting the healing or in fact contributed to its occurrence in the first place, as was the case with mine years back.

I'm always in favor of changing dressings twice per day. I would always be very careful taking up the dressings, loosening them up with wound spray before peeling off the dressings to ensure they do not stick.

I would also see a wound care specialist or good podiatrist. Mine managed my heel sore just fine, debriding as necessary.

[SCI-Nurse]

It would be best to avoid the compression socks until this area is fully healed. You get pressure as well as friction/shear over your heal when applying them. If you must use something for your blood pressure when up, then use an Ace wrap instead and avoid applying over the wound.

If using just a hydrocolloid dressing now, no need to use any ointment, etc. underneath; in fact that can defeat the benefit of using hydrocolloid for a wound at all. No need to cover it with anything either. Hydrocolloid is designed to be changed every 2-3 days.

Of course you need to keep pressure off it still, wearing heel elevating boots at night, and avoiding wearing a shoe that puts any pressure on that area when up in your chair. You also need to think seriously about how you got this pressure injury, and take measures to avoid it happening again.

Silicon dressings (tape or sheets) can be helpful in smoothing out scar areas, especially for those who are keloid formers. It is not designed to be used on broken skin though.

(KLD)

[Rook98006]

Thank you both for responding. Changing it every couple days sounds good. Feels strange not being able to look at it due to being covered but I'll manage. Keeping pressure off of it is not to difficult. How I got it is another story...couple places on the shower chair that are easily banged into...not as careful as I should be transferring into my power chair. Who knows? Will keep a better eye on those maneuvers. Thxs again.

[crags]

always wear soft booties for skin protection when transferring, sitting on the commode chair, moving/being moved in the chair