Healthy Skin Healthy Skin_Issue 12_Fall 2023 | Page 12

Q & A

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& With ...

Catherine T . Milne , MSN , APRN , CWOCN-AP , Connecticut Clinical Nursing Associates , Bristol , Conn .
As part of the Medline Skin Health educational webinar series , advanced practice WOC nurse Catherine T . Milne joined us for a discussion on repositioning and offloading . Here , we present a portion of the live question and answer session that followed the webinar .

Sacral and heel offloading

QDo good offloading devices eliminate the need for therapeutic support services ?

A Absolutely not . That ’ s one of the biggest myths that I see . You will always need a therapeutic support surface if you have a patient who is at high risk , however you define that . I also think that people who are clinically dehydrated or severely anemic , or people who are on vasopressors , need a
therapeutic support surface . And especially if you have somebody in critical care that you ’ re only doing micro turns on , they definitely need a therapeutic support surface .

QWhat do you mean by ‘ It ’ s not what you put on , it ’ s what you take off ’?

A I ’ m talking about putting a dressing on and how you ’ re taking the pressure off in
terms of complete offloading or pressure redistribution . People may think you can just put a dressing on it — and some dressings actually have data about redistributing pressure — but it is not a substitute , it ’ s an adjunct to a good repositioning plan and good repositioning devices .

QWhat ’ s your opinion on a ‘ heels up ’ product ?

A That is a very wide wedge device that is usually not high
density , high quality foam . The issue is that if it is not sized right for the patient , you will actually compress the popliteal artery or their branches , and when you position their heels in the air , you ’ re going to hit the popliteal base and it can be a problem with the entire angiosome . If people are moving and repositioning , making small movements themselves , then it is not quite as efficient as a typical heel boot .
12 Healthy Skin