title: Heel damage and epidural analgesia: is there a connection?
abstract: OBJECTIVE
  To determine heel pressure injury prevalence in surgical patients prescribed epidural analgesia and identify intrinsic and extrinsic factors associated with heel damage in this patient cohort.
  
  
  METHODS
  A descriptive study was used to investigate intrinsic and extrinsic variables associated with recorded heel observations at a private hospital in Victoria, Australia. We recruited a sample of 29 consecutive non-emergency participants undergoing general anaesthesia for major surgery, who were prescribed epidural analgesia postoperatively. A total of 58 heel observations were made.
  
  
  RESULTS
  Heel damage prevalence in the study sample was 13.8% (n=8).
  
  
  CONCLUSIONS
  Intrinsic factors associated with this complication included intra- and postoperative hypotension, vascular disease, smoking, chronic obstructive pulmonary disease, and multiple disease burdens. Extrinsic factors associated with heel damage included thromboembolic deterrent stockings and the postoperative ward use of heel protectors designed for use in operating theatres. It is hoped that the study findings will assist improvements in the assessment of heel damage risk and promote the pressure prevention strategies required by this patient cohort.
authors.affiliation: St John of God Hospital, Bendigo, Australia. christinebattersby@hotmail.com
authors.forename: C M
authors.initials: CM
authors.lastname: Loorham-Battersby
authors.forename: W
authors.initials: W
authors.lastname: McGuiness
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015360:Analgesia, Epidural / Q000009:adverse effects*; D054869:Clinical Audit; D015897:Comorbidity; D005260:Female; D006365:Heel; D016304:Hospitals, Private; D006801:Humans; D008297:Male; D008875:Middle Aged; D015403:Nursing Evaluation Research; D011182:Postoperative Care / Q000009:adverse effects / Q000379:methods / Q000451:nursing; D003668:Pressure Ulcer / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D015995:Prevalence; D011482:Protective Devices / Q000009:adverse effects; D018570:Risk Assessment; D012307:Risk Factors; D053828:Stockings, Compression / Q000009:adverse effects; D014739:Victoria / Q000453:epidemiology