Pressure necrosis

Areas subject to pressure or trauma during walking or bed rest are the first to show evidence of trophic change, ulceration or gangrene.

These include:

• heels - lift heel from the bed, look at bottom, back and lateral side
• malleoli
• skin over the head of the fifth metatarsal
• toes - tips and in between, where the nail of one toe rubs against the side of the next
• ball of the foot

Signs of pressure necrosis include:

• skin thickening
• blistering
• ulceration
• discolouration - blue, purple, black (gangrenous)