title: Changes in heel skin temperature under pressure in hip surgery patients.
abstract: OBJECTIVE
  The aim of the study was to examine the effect of external pressure of the bed surface on heel skin temperature in adults in the first 3 days after hip surgery.
  
  
  METHODS
  A quasi-experimental study in a prospective, within-subjects, repeated-measures design.
  
  
  METHODS
  This study was performed at 2 acute-care hospitals.
  
  
  METHODS
  Eighteen subjects (9 men and 9 women) with a mean age of 58.3 (±16.1) years were recruited after hip surgery at the 2 hospitals.
  
  
  METHODS
  Temperature sensors were placed on the plantar surface of each foot, close to the heels. Measures were taken when the heels were (1) suspended above the bed surface for 20 minutes (preload), (2) on the bed surface for 15 minutes (loading), and (3) suspended again above the bed surface for 15 minutes (unloading).
  
  
  METHODS
  Heel skin temperature and demographic data.
  
  
  RESULTS
  Heel temperature increased during loading and unloading in both legs on postoperative days 1 (P = .003) and 3 (P = .04) but not on postoperative day 2. Heel temperature in the nonoperative leg decreased in the first 3 minutes of unloading on postoperative days 2 (P = .02) and 3 (P = .01).
  
  
  CONCLUSIONS
  Heel temperature increased with loading and unloading on postoperative days 1 and 3. Upon immediate unloading, hyperemic response was present only in the nonoperative leg. Keeping the heels off the bed surface at all times may avoid heel skin temperature changes and prevent tissue damage. Further research is needed to identify the mechanisms that explain the effect of external pressure on heel temperature.
authors.affiliation: School of Nursing, San Jose State University, California, USA.
authors.forename: Vivian K
authors.initials: VK
authors.lastname: Wong
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Stotts
authors.forename: Harriet W
authors.initials: HW
authors.lastname: Hopf
authors.forename: Glenna A
authors.initials: GA
authors.lastname: Dowling
authors.forename: Erika Sivarajan
authors.initials: ES
authors.lastname: Froelicher
mesh_terms: D019644:Arthroplasty, Replacement, Hip; D002140:California; D005260:Female; D016523:Foot Ulcer / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011312:Pressure; D011446:Prospective Studies; D012881:Skin Temperature; D016683:Supine Position