What a Prophylactic Dressing Can and Cannot Do for a Heel

There is a thread on an American nurses' forum with a four-word title: "To mepilex or not?" The nurse who started it described an arrangement many wards will recognise. Once a patient's risk score crossed a threshold, foam dressings went onto the sacrum and both heels more or less automatically, and nobody had ever explained when a dressing earns its place and when turning would do. One reply answered in four words of its own: "No dressing prevents pressure."

The thread is American, but the question is not. I've spent more than thirty years supplying devices that float the heel, so you might expect me to side with that reply. I don't, entirely. A dressing and a floating heel do different jobs, and the formal evidence for each is thinner than either camp tends to admit.

Put plainly we can say that a dressing changes the surface. Offloading changes the load.