Boggy Heels. Where did that term even come from? To understand what a ‘boggy heel’ is and how it possibly relates to the development of pressure injuries, why not start with the definition of a bog. A bog is described as a wet ground too soft to support a heavy body. Now, in medical terms, ‘boggy’ refers to abnormal texture of tissues characterized by sponginess, usually because of high fluid content. The NPIAP defines deep tissue injury as tissue that is painful, firm, mushy, warmer, or cooler to the touch compared with adjacent tissue. And 42% of all DTIs manifest on the heel. Looking at the big picture, it is easy to see how the presence of a boggy heel can indicate the development of a heel pressure injury. Now, the question is what can be done?

When figuring out the best care plan for managing a boggy heel, more questions seem to arise. Is it a precursor to a significant heel pressure injury? Or is it just an early indicator that could be reversed with proper intervention? Is it more likely to happen in the older population? Or those with edema? Amidst all of the questions, however, the consensus on where to begin always lands in one spot — Good heel assessment!

Heel assessments performed consistently on admission and throughout a patient’s length of stay are important for early diagnosis and prevention of pressure injuries. Patients with unusually warm or cool heels should be checked for other risk factors like venous or arterial disease, diabetes and immobility. Evaluating pain levels is also important.

If heel DTI is suspected, patients should automatically be fitted with a heel offloading boot. Lower extremity devices have come a long way and today do much more than just offload the heel and cushion the foot. Pressure injuries on the heel are hard to, well, heal. And the onset of a boggy skin texture is not the time to hesitate. Learn more about heel protection devices for early prevention and intervention.

https://www.sciencedirect.com/science/article/pii/S0268003320302126
https://npiap.com/