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Preventing heel pressure sores after trauma or surgery

What are heel pressure sores?

Heel pressure sores are a big problem after a surgery or any situation where a child is unable to move about in bed.

They can affect the lower back, heels, and toes.

picture of a leg showing where pressure sores may develop

Lying still for too long causes pressure on the bone of the heel or any bony contact point which squashes the skin.

Diagram showing the layers of the skin and how a pressure sore develops

If this is not relieved, it will cause tissue damage leading to a pressure sore.

They only take a few hours to happen but can take many months to heal so prevention is much better than cure.

Photograph of a child with a heel pressure sore

Children with plaster casts or splints on their legs are even more at risk as we cannot see their heels. The plaster or splint is harder than the mattress, so there is even more pressure on the heel when it is lying on a surface.

leg in a cast

How to prevent pressure sores

  • Reposition your child every 2 to 4 hours to relieve pressure areas, or prompt your child to do this if they are able. Look for any red marks on your child’s skin every day as this is a sign of pressure damage.
  • Make sure their heels are elevated off the mattress with a support under the calf. Especially if your child has a leg cast on.
  • Consider your child is high risk for pressure sores if they have spina bifida, Cerebral palsy, Charcot marie tooth, osteogenesis imperfecta or if they have a hip spica cast. A pressure mattress might be needed as well as more repositioning.
  • Make sure your child is eating well and healthily to make sure their skin is healthy.
Do not
  • Leave your child’s skin covered in moisture such as sweat or wee. This causes skin damage and makes pressure sores more likely.

Contact us

If you feel that your child is affected by one or more of the issues discussed in this resource in particular:

Contact your specialist healthcare team or the Tissue Viability Specialist Nurse via switchboard on 0114 271 7000 

Email Tissue Viability: scn.tr.schtissueviability@nhs.net

Your general practitioner (GP) or specialist healthcare team can refer your child to Tissue Viability at Sheffield Children’s Hospital if you and your child need further support.

If you think there is an issue with the plaster cast please contact the plaster room via switchboard on 011 427 17538

Is something missing from this resource that you think should be included? Please let us know

Contact us


Please note: this is a generic information sheet relating to care at Sheffield Children’s NHS FT. These details may not reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If this information has been translated into another language from English, efforts have been made to maintain accuracy, but there may still be some translation errors. If you are unsure about any of the guidance in this resource or have specific questions about how it relates to your child, always ask your healthcare professional for further advice.

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S10 2TH

United Kingdom

Switchboard: 0114 271 7000

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