Concerned about heel pressure sore after tibia surgery, should I seek help?

[Em1988x]

Anyone a nurse / wound specialist? Or have experience in these. I’m recovering from leg fracture surgery. Had tibia fracture 2 weeks ago and IM nail in place, so I’m not in a cast. Been 7 days since operation, and no one told me I had a pressure sore on my heel 🙈 everyone thought it was dirt and just sore. Hospital didn’t have my heel hanging over the cushion, they didn’t advise that should be the case and so I carried that on st home also. It was only few nights ago I looked at my heel properly because my daughter touched it and I couldn’t feel abit of it. I had my follow up at hospital next day, told doctor and nurse, doc looked barely interested and said it will heal and just leave pressure off it. Nurse confirmed to him it was a pressure sore and she just gave me some dressing to put on it at night. Although only gave me two of them. When I questioned doc more he said it’s just like a blister on your foot so wil go like that and only concern and call if it smells or puss comes out, but oozing like out of a blister is fine.

nighttime is horrible because I keep waking thinking my heel is touching the cushion and I keep thinking worse case scenario that it’s really bad and I’m going to lose my foot. It looks really bad to me and when I google that it’s red non blanchable and has black around it, it says it should be treated right away by wound specialist. Given that it’s the weekend now, am I safe to wait until Monday?

I am healthy otherwise, non smoke 8.5 st 5.5 / 38

It sounds like a DTI (deep tissue injury) op. I’m a nurse and in hospital, all we would do is keep pressure off, elevated on pillows or if the patient is likely to not comply we sometimes use special foam boots or foam heel cups to protect. I take it it’s definitely not an open sore? Obviously I couldn’t grade without seeing but by your description that’s what it sounds like. Is your nutrition good right now and you’re not diabetic?

If it’s a pressure sore it’s reportable especially if it occurred in hospital

advice would be to keep it off loaded. If lying down or leg is up make sure the heel is free floating and it’s not resting on anything

can you post a pic?

I posted a pic but not been reviewed yet

When it’s deep tissue, does that mean there’s nothing that can be done for it?

They didn’t seem that bothered 😕 didn’t report it and said yesterday that in 4 weeks when they see me for leg x ray they will see how it’s doing then

I wouldn’t say it’s open, but I had cracked heals before it happened. They said not to wash and keep dry

Image this morning

Your photos aren't showing. Are you a new poster? IIRC new posters can't post photos.

I’ve posted in other forums on here before 🙈

Yes op the most vital treatment is offloading and it should start to improve. I work with the elderly and in most cases with strict repositioning they’re very much improved in a few weeks. If you’re really worried about it at night you could get something like this:
https://amzn.eu/d/0d6V271C

we use the boots but they seem very expensive to buy. The best way to think about it is it’s a bit like a bruise but in a dti pressure to the area has caused damage underneath the skin. If you hadn’t have found it, it could have developed deeper which is much harder to heal. Pressure ulcers are a particular problem in healthcare and it’s a stark reminder that even younger people are very much at risk. Orthopaedic wards are normally very good at prevention due to the increased risk with immobility and casting. It’s good you’ve caught it but obviously not so good you’ve sustained it from hospital. We incident report them when they’re found in hospital but I don’t think tissue viability or wound care would be very interested in it unless it was something worse as it can be managed, just it’s rubbish you haven’t been given any information

Thank you. I will order one of those. I looked at the one that was a boot and prevented foot drop but they were £40 or more. Is this just as good to use what you suggested instead of the boot?
is there anything else I need to be doing? I can’t get about much, just use my frame back and fourth to kitchen or toilet and then either in bed or on sofa. Should I get up for a certain amount of time each day?

My images above are showing now

Just posting to bump this as I would be most unhappy to have that on my heel and I hope someone with expertise comes along soon xx

Thank you 🙏

Not diabetic and diet is good. I’ve started vitamin d, c, zinc and magnesium since leg break. And also on protein shakes. The pics have now come through

I’m really sorry you’ve ended up with this, if you can I would send some photos to your GP on Monday and ask to be referred to the district nurses. They may be able to order you some equipment to help while you’re immobile and help reduce your risk of developing pressure sores elsewhere. This can be things like pressure cushions, pressure mattresses, those heel protecting boots. But as other posters have said, the main thing is to keep pressure off your heel as much as you can. If it opens up or becomes more painful, then please ring 111 over the weekend. Otherwise, I would try and get the district nurses involved (I assume you’re basically housebound at present? As they will only accept referrals for housebound patients). Good luck OP, keep the thread updated with how you get on

Thank you. Yes, I will be calling doctors Monday and asking if they can send someone to me or refer me. I will also mention about getting some kit in. So annoying because I should be on my way to weight bearing on my foot now and regaining strength and in such a shit place mentally now 😕 I have two children 9 and 12 and single mum. Their dad helps loads and also my parents but feel helpless that I can’t do anything with them

assuming you’re not bed or chair bound non of this equipment is needed. The nurse in the PP gave great advise. Basically the treatment for a DTI on a young patient like you is offloading. You have said you are overwise healthy, not diabetic, no heart / circulatory conditions, have good nutrition. Make sure you offload the heel, stay hydrated and eat well and you’ll heal just fine. Obviously you can call your GP or 111 if anything changed or you’re concerned.

You don’t need specific equipment - you just need to off load the heel

Am I best off getting something for offloading the heel? Like what was suggested further up. At the moment I try and build cushions up because I also have a broken leg which is undressed

Cushions are fine. Are you able to sit / lie comfortably with cushions or pillows under your calf so you heel is hanging free off the end?

So long as your foot is off the end of the cushion that’s all you need to do. You don’t need anything special

Seems a challenge every night to position cushions and leg seems to slide back down and my heel touches faintly sometimes.