Best products from r/woundcare

The most important thing you can do for a pressure ulcer of the heel is ensure there is no pressure on the heel. His foot should never be resting on the mattress. Use a pillow under the calves and instruct all caregivers to assess that the heel is off the mattress at all times. There are also soft "heel protector" boots available for offloading the heel. These boots have a hole cut out where the heel is so no matter how a patient is positioned, no pressure will be on the heel. Look at this link:

DM Systems Inc Heelift, Standard, Smooth https://www.amazon.com/dp/B01AMLKJ1G/ref=cm_sw_r_cp_apa_i_mHaFDbE2HTGE8

In terms of wound care:

With "stable eschar" of the foot, we leave the eschar in place - no debridement. Stable eschar is dry and intact, like a big scab. And stable eschar functions as a protective covering for the wound - essentially the body has made its own dressing - so we leave it alone. Often you will care for stable eschar by leaving the area open to air, keeping it dry and cleaning the eschar with betadine 1-2x daily.

Now if it is draining or soft or with a bad odor, or if there is more than 2 cm of redness around the wound, your best bet would be an antimicrobial dressing. The reason they are not debriding it may be because his underlying condition may make healing difficult or impossible. Things like circulatory diseases, advanced heart or kidney disease and malnutrition will make healing difficult - then the goal becomes wound maintenance instead of healing. Bottom line, if you debride a wound, the patient has to have the capacity to heal the hole you just made in them, or you've just made the problem worse.

Even if he cannot heal, an antimicrobial dressing may be your best bet. An antimicrobial dressing will keep it odor-free and less likely to cause serious infection. There are many options. If draining heavily, consider a silver impregnated alginate (aquacel AG). If draining little, consider an antimicrobial gel (iodosorb) under a dry dressing. There are also some antimicrobial foam dressings on the market (hydrofera blue), which are good for moderately draining wounds. If the goal is to debride the wound without using surgery, many practitioners favor temporary use of product called quarter strength dakin's solution, which is both effective for debridement and highly antimicrobial.

All of these options should be discussed with his care provider. Hope this helps and good luck!