To request a Posey Catalog or speak with an associate,call 1.800.44.POSEY (76739) or visit us online at Posey.comPosey Company • 5635 Peck Road, Arcadia, CA 91006-0020 USA • Phone: 1.800.447.6739 or 1.626.443.3143 Fax: 1.800.767.3933 or 1.626.443.5014 • www.posey.com ©2012 Posey Company. All rights reserved. MK1538 REV B 020812

Discover the Posey® “Heeling” Power

“Heel ulcers can be reduced using a total-patient care approach and Heel Offloading Devices.” 1

Wound ManagementYour Partner in Pressure Ulcer Prevention

1. Fowler E, Scott-Williams S, McGuire JB. Practice Recommendations for Preventing Heel Pressure. Ostomy Wound Manage. 2008 Oct;54(10):42-8, 50-2,54-7.

WOUND MANAGEMENT

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A Heel Pressure Ulcer

The Anatomy of the Heel

According to the National Pressure Ulcer Advisory Panel (NPUAP), a pressure ulcer is a localized injury to the skin and/or underlying tissue that usually develops over a bony prominence as a result of pressure or pressure with shear or friction forces.2

What are the risk factors associated with heel pressure ulcers? There are several known factors that increase a patient’s risk of developing a heel pressure ulcer, including:

• Lacksfat-filledfascialintersticestoabsorbthecompressiveforces of prolonged pressure or shear.

• Thebloodsupplyispoorandthereisnounderlyingmuscleto distribute pressure.

• Prolongedpressurecanleadtoischemia.4

The above factors can be applied to all pressure ulcers, not just those affecting the heel.3

• Dehydration• Frictionandshearforces• Diabetes• Peripheralvasculardisease• Hipfractures• Lowalbuminlevels/anemia• Obesityorlowbody-massindex

• Inadequate/malnutrition• Advancingage• Abnormalitiesofcirculation• Sensorydeficiency• Immobility• Majorsurgery• Multiplehealthproblems

(comorbidities)

2

2. NationalPressureUlcerAdvisoryPanel.PressuredefinitionandstagesrevisedbyNPUAP,2009.3. LaurieSwezeyRN,BSN,CWS,CWOCN.PreventingHeelPressureUlcers.4. RomanesGJ.Cunningham’sManualofPracticalAnatomy,VolI,14thedition.London,UK:OxfordUniversityPress;1976:156–158.

Posey® PRO-heeLx®

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Complications of Heel Pressure Ulcers• Theincidenceorheelpressureulcersrangefrom19%to32%inacutecare

facilities.5

• Long-termcarefacilitieshavereportedprevalenceratesashighas27.3%—ofthese,23.6%wereheelulcers.6

• Heelpressureulcersaccountforapproximatelyonethirdofallpressureulcersinacutecareandmixedacutecare/long-termcaresettings.6,7

• Canleadtoinfection,cellulitis,osteomyelitis,septicemia,limbamputation,ordeath.8

• Immobilityisaprimaryriskfactorfordevelopingaheelpressureulcer,itisapresentfactorinupto87%ofcases.9

• Patientswithafracturedhipandopenreductionwithinternalfixationhavea45.1%probabilityofdevelopingapartial-thickness(StageI-II)heelpressureulcer.10

5. USDepartmentofHealthandHumanServices.ClinicalPracticeGuidelineNumber15.TreatmentofPressureUlcers.Rockville,Md:AHCPRPublicationNo 95-0652H.December1994:(1):13–14.6. VanGilderC,WashienkoC,EcksteinA,DeckerS,MacFarlaneG.2005internationalpressureulcerprevalencesurveyresultsforlong-termacutecarefacilitiesin

the United States. 7. AmlungSR,MillerWI,BosleyLM.The1999NationalPressureUlcerPrevalenceSurvey:abenchmarkingapproach.AdvSkinWoundCare.2001;14(6):297-301.8. Fowler E, Scott-Williams S, McGuire JB. Practice Recommendations for Preventing Heel Pressure. Ostomy Wound Manage. 2008 Oct;54(10):42-8, 50-2,54-7.9. BlackJ.Preventingheelpressureulcers.Nursing2004;34:17.10. StottsNA,DeosaransinghK,RollFJ,etal.Underutilizationofpressureulcerriskinhipfracturepatients.AdvWoundCare1998;11:32-8.

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WOUND MANAGEMENT

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*Likelyanunderestimatesincethesewoundsusuallyrequireadditional rehabilitation to heal.

11.AllmanRM,GoodePS,BurstN,BartolucciAA,ThomasDR.Pressure ulcers, hospital complications, and disease severity: impactonhospitalcostsandlengthofstay.AdvWoundCare.1999;12(1):22–30.

12.MedicalNewsToday.Clinicaltrialshows96%improvementinpressure ulcer healing among nursing home residents. March 11, 2006.

13. Rosenthal MB. Nonpayment for performance? Medicare’s new reimbursement rule. New England Journal of Medicine. 2007 Oct. 18;357(16):1573-5.

14. Gupta S. Guidelines for Managing Pressure Ulcers with Negative PressureWoundTherapy.AdvancesinSkin&WoundCare.2004;17(2):1-16.

x = dollars y = Estimated Incremental Costs of Managing a Pressure Ulcer, Stages I-IV 14

{

yx

$ Cost of Managing a Pressure Ulcer37,450 -

14,450 -

600 -

400 -

200 -

50 -

Maximum costof a Posey Heel

Offloading Device

{$50Stage I $200

Stage II +$200

Stage III +$14,000

Stage IV +$23,000

Take the Pressure OffLightweight heel protector lifts painful burdens from patients, families, and staff.CMS no longer covers the cost of hospital acquired pressure ulcers.13

More Associated Costs•Patientssufferpainandareimmobileand

staysareextended.

•Familiessufferburdenofcaringfordependent loved ones.

•Nursesbearadditionalburdenanddemandfor care.

Additional Costs of Heel Pressure Ulcers…

Cost of Pressure Ulcers

GuidelinesforthePreventionandManagementofPressureUlcersWOCN2010

“While the overall average hospital stay is five days and costs about $10,000, the average pressure ulcer related stay extends to between 13 and 14 days and costs between $16,755 and $20,430, depending on the medical conditions.”

• Inatertiaryhospital,totalcostofcareforhipfracturepatientswithapressureulcer(unspecifiedtype)averaged$37,288comparedto$13,924inpatientswithoutpressureulcers.11

• PatientswithDMandperipheralarterialdiseasemayneedpartial-footorbelow-kneeamputation.

• Pressureulcersarereportedtobeoneofthemostcommonsourcesoflitigationinvolvingnursinghomecare.12

– Filedclaimsforpressureulcersarereportedtobethesecondmostcommonfiledclaimafterwrongful death.

– Theaveragecompensationforpressureulcercasesisalmost$1million.12

4

Posey® PRO-heeLx®

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Protect and Prevent“The incidence of heel ulcers can be reduced using a total-patient care approach and heel offloading devices.”17

“Because pressure ulcers may develop after only a few hours of immobility-induced pressure, devices may need to be in place soon after admission to be effective in the prevention of pressure ulcers.”18 “ICUpatientswhodevelopedpressureulcersdidsowithinthefirst72hoursofadmissiontotheICU.Fifteenpercentofelderlypatientswilldeveloppressureulcerswithinthefirstweekofhospitalization.”19

“Completeeliminationofheelpressureusingapressure–reliefdeviceiscritical.”20

• AstudyconductedbyHaltonHealthcaretitled“Stomp Out Heel Ulcers”: A Pressure Ulcer

References:15. EPUAP and NPUAP - European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel. Treatment of pressure Ulcers: Quick Reference Guide.

WashingtonDC:NationalPressureUlcerAdvisoryPanel2009.16. RichardBishop,RN,BScN,IIWCCandAllisonTheriault,RN,BScN,IIWCC(c),Oakville,Ontario,Canada.StompOutHeelUlcers:APressureUlcerPreventionInitiative

inaCommunityBasedHospital.17. Fowler, E., Scott-Williams, S., McGuire, J. Practice Recommendations for Preventing Heel Pressure Ulcers, Ostomy Wound Management 2008; 54(10):42-5718. Rich,ShaynaE.;Shardell,Michelle;Margolis,David;Baumgarten,Mona.PressureUlcerPreventiveDeviceUseAmongElderlyPatientsEarlyintheHospitalStay,

NursingResearch:March/April2009–58(2):95-10419. Stechmiller,J.,Cowan,L.,Whitney,J.,Phillips,L.,Aslam,R.,Barbul,A.,Gottrup,F.,Gould,L.,Robson,M.,Rodeheaver,G.,Thomas,D.,Stotts,N.Guidelinesforthe

preventionofpressureulcers,WoundRepairandRegeneration,March–April2008,16(2):151–16820.Langemo,D,etal.HeelPressureUlcers:Standguard,AdvancesinSkinandWoundCare,June2008,21(6):282-292.

A Community-Based Hospital StudyPreventionInitiativeinaCommunityBasedHospital “included an algorithm to assess patient risk for developing a heel ulcer and methods to removeheelpressure.”ThePoseyPRO-heeLx“was chosen to be the heel protective device forthisinitiativeasitfulfillstheInternationalGuideline for Prevention of Pressure Ulcers recommendations.15 These guidelines state that “heel protection devices should elevate the heel completely (offload them) in such a way without putting pressure on the Achilles tendon”. This new device ensures offloading is maintained even when patients move their legs.” The study was “conducted as a part of the Hill-RomInternationalPressureUlcerPrevalenceSurvey in February 2011. The number of heel pressure ulcers across the organization dropped from35ulcersor42%ofallulcersto17ulcersaccountingfor29%.AnHHSprevalenceconductednine months later in October 2011 demonstrated that these improvement have been sustained. Heels are no longer the most common anatomical location for pressures ulcer.”16

5

WOUND MANAGEMENT

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Cat. Description6218S Small6218WS Small with Stabilizer Wedge6218 Medium6218WM Medium with Stabilizer Wedge6218L Large6218WL LargewithStabilizerWedge6219 Stabilizer Wedge

Large opening helps ensure adequate ventilation and cooling of the heel

and eases patient monitoring

2” heel lift floats the heels above the bed surface and helps protect

against heel pressure ulcers

Optional Stabilizer Wedge helps prevent complications related to lateral rotations of the foot

Features of the PRO-heeLx®

Posey® PRO-heeLx®

ORTHO-WICK™ INNER LINER

BREATHABLE NYLON AND ORTHO-WICK™ INNER LINER ALLOWS MOISTURE & HEAT TO ESCAPE

BREATHABLE NYLON

www.posey.com 7

The outer fabric is made of breathable nylon, allowing moisture and heat to

migrate away from the foot

Quality construction allows for laundering while maintaining its

shape and resiliency

Ortho-Wick™ inner-liner material for moisture management and

patient care and comfort

Durable straps with foot drop functionality

Durable straps with foot

Optional Stabilizer Wedge helps prevent complications related to lateral rotations of the foot

WOUND MANAGEMENT

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“Heel offloading devices solve most problems associated with pillow offloading and are more efficient because the devices stay in intimate contact with the foot and lower leg and can remain in place 24 hours a day.” 21

Small, medium and large sizes available to customize fit any patient type

Pillow Solution vs. PRO-heeLx® Solution

21 Fowler, E., Scott-Williams, S., McGuire, J., Practice Recommendations for Preventing Heel Pressure Ulcers, Ostomy Wound Management 2008;54(10):42-57

8

Pressure Test Results Show 100% Heel Pressure Relief

Unprotected Patient – 8.0 PSIProtected with Posey PRO-heeLx – 1.8 PSI

This guide is for comparison purposes only. Data based on internal bench testing and on file at Posey.

> = 987654321

> = 0

PSI

Posey® PRO-heeLx®

www.posey.com 9

CorrectPlacementPlacethesleeveinsidethePRO-heeLx and the tubing through the side of the boot through the cross straps.

Proper placement of Intermittent Pneumatic Compression (IPC) tubing in the PRO-heeLx®

PRO-heeLx® Application Instructions

AlternativeapplicationofPRO-heeLx

PRO-heeLx properly strapped along

the side

Attach two upper straps along the side

of the boot

ProperapplicationofPRO-heeLx Pressure-Relieving Heel Protector

Place foot inside Firmly attach two side straps

PRO-heeLx properly strapped

Criss-cross and attach two

upper straps

IPC Tubing

IPC Sleeve

PRO-heeLx

AlternativeinstructionsforpatientsusingIPCtubing

Before use, make sure to read the instructions accompanying the product. A copy of the instruction sheet is included with the product and can also be downloaded at www.posey.com.

WOUND MANAGEMENT

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• Aidsinthehealingandprevention of heel and toe ulcers.

• Largeheelcavityhelpskeepheel isolated and free from pressure.

• Polymersplintcanaccommodate up to 45-degreesofplantarflexion.

• Machinewashablelinersmadefrom moisture absorbing Ortho-Wick™ to help keep skin dry.

• Theoptionalambulationsoleeasily attaches without tools.

•Highresiliencefoamheeloffloadingdevicefloatstheheelandhelpsreducetheriskoffootdrop.•Openheelcutoutallowstheheeltobesuspended,whichreducesheelpressure.• Heelandsideventilationopeningshelpprovideaircirculationanddissipateheatbuildup.• Adjustablefoamelevationblockhelpsoptimizeindividualpositioningandheellift.• Adjustablestrapsproperlypositionthepatient’sfoottoreducetheriskoffoot

drop.

6145 Premium Heel Guard 14”L x 11”H6145BT Traction Heel Guard 18”L x 11”H6146 Add-On Traction Bar Assembly Only

6147 Deluxe Podus BootAvailable Sizes: SM/ML

6148 Deluxe Podus Boot with Ambulation Sole Available Sizes: SM/ML

6145

Posey Deluxe Podus Boot

Posey Premium Heel Guard

10

Sole

61486148

6147

Other Posey Heel Offloading Devices

Posey® Skin Protection

www.posey.com

Posey SkinSleeves™ arm and leg protectors are a versatile non-compression skin covering that offers a discreet way to protect your patient’s fragile skin from tears, bruises and abrasions. Posey SkinSleeves™ are comfortable and easy to apply.

Cat. # Size Skin Color Style PkgARM

6000S Small Light Regular 1 pair6003S Small Dark Regular 1 pair6000 Medium Light Regular 1 pair6000B Medium Light Regular 25 pairs6002 Medium Light Padded 1 pair6003 Medium Dark Regular 1 pair6000L Large Light Regular 1 pair6000XL X-Large Light Regular 1 pair

ARM WITH ELBOW GEL PAD

6000GS Small Light Regular 1 pair6000GM Medium Light Regular 1 pair6000GL Large Light Regular 1 pair

LEG

6001 Medium Light Regular 1 pair6004 Medium Dark Regular 1 pair6005 Medium Light Padded 1 pair

22.Bank,D,Nix,D.Preventingskintearsinanursingandrehabilitationcenter:aninterdisciplinaryeffort.OstomyWoundManagement.2006;52(9):38–46

www.posey.com

•Comfortablesocklikecoveringsthathelpprovidecomfortandprotectagainstfrictionandshearforces.•Madefromalatexfreeflexiblestretchyarnwitheitheracushionedfoam

pad(6224)ora“Gel”pad(6224G)sewntotheinside.•Expandableknittedsleeveiseasilyremovableandhelpskeep

extremitieswarmwithoutrestrictingbloodcirculation.•Availableinfoursizes.Machinewashable.Onepairperpackage.

Cat. # Size Fits Limbs* Qty.6224S/GS Small Up to 8½” Circumference 1 pr.6224M/GM Medium Up to 11” Circumference 1 pr.6224L/GL Large Up to 13½” Circumference 1 pr.6224XL/GXL X-Large Up to 16” Circumference 1 pr.

6224

6224G

6224G

INNER GEL PADINNER FOAM PAD

* FITTING GUIDELINES - Knitted Heel/Elbow Protectors are intended to fit as a comfort product. Actual fit will depend on individual anthropometric measurements and patient comfort level. These protectors will stretch up to 30%.

6224

Posey Heel/Elbow Protectors

Posey SkinSleeves™ Arm and Leg Protectors

Posey SkinSleeves™ arm and leg protectors are a versatile non-compression skin covering that offers a discreet way to protect your patient’s fragile skin from tears, bruises and abrasions. Posey SkinSleeves™ are comfortable and easy to apply.

Cat. #ARM

6000S6003S60006000B600260036000L6000XL

ARM WITH ELBOW GEL PAD

6000GS6000GM6000GL

LEG

600160046005

22.Bank, D, Nix, D. Preventing skin tears in a nursingOstomy Wound Management. 2006; 52(9):38–46

Posey SkinSleeves™ Arm and Leg Protectors

SkinSleeves™ have been shown to reduce skin

tears by 53% 22

SkinSleeves™Decreasing the Risk of Skin Tears

11

Posey Skin Care Protectors

6000

Posey® PRO-heeLx®WOUND MANAGEMENT

PoseyCompany•5635PeckRoad,Arcadia,CA91006-0020USAPhone:1.800.447.6739•Fax:1.800.767.3933•Web:www.posey.com

Wound ManagementYour Partner in Pressure Ulcer Prevention

Cost-Effective Wound Management Solutions

6145

6218

6219

6224

6147

6000G