A friction blister on the heel is a common injury caused by the repeated rubbing of skin against a shoe or sock, leading to a fluid-filled pocket forming underneath the upper layers of the skin. This fluid serves as a natural cushion, protecting the underlying tissue. The heel is susceptible to this injury due to constant movement and pressure. Properly wrapping the blister reduces friction, cushions the area, and prevents rupture, supporting the body’s natural healing process.
Preparing the Blister for Bandaging
The blister site must be thoroughly cleaned before bandaging to minimize infection risk. Gently wash the surrounding skin with mild soap and water or an antiseptic solution. For small, intact blisters, leave the blister roof undisturbed, as it provides a sterile barrier over the wound.
If the blister is large, painful, or likely to rupture, draining it may be necessary. Use a sterile technique, such as sterilizing a sewing needle with an alcohol wipe. Carefully insert the needle near the edge of the blister to allow the fluid to drain gently, leaving the protective skin flap in place. Once drained, pat the area dry and apply a topical antibiotic ointment to the puncture site before bandaging.
Applying the Heel Wrap Technique
The primary goal of wrapping a heel blister is to redistribute pressure and create a low-friction surface that moves with the skin. Necessary materials include a primary dressing, such as a hydrocolloid bandage or sterile gauze, cushioning material like moleskin or felt, and medical tape. Hydrocolloid dressings are often preferred for formed blisters because they promote moist wound healing and act as a waterproof seal against contaminants.
To offload pressure from the blister’s center, a “donut” pad technique is highly effective. A piece of moleskin or felt is cut into a shape slightly larger than the blister, and a hole is then cut in the center, perfectly encircling the blister without touching it. This padding is adhered to the skin, creating a raised barrier that shields the blister from direct contact and friction. The primary dressing, whether a hydrocolloid patch or a piece of sterile gauze, is then placed directly over the blister and the donut hole.
Securing the wrap on the heel’s curved and mobile surface demands a specific taping strategy to prevent the dressing from bunching or peeling during movement. Anchor strips of medical tape can be applied to the sides of the foot, followed by a figure-eight pattern that wraps around the heel and crosses over the front of the ankle. The tape should be applied smoothly without excessive tension, ensuring it conforms to the contour of the heel without causing wrinkles that could create new friction points. Rounding the edges of the tape before application helps prevent the corners from lifting and rolling up, which can compromise the seal.
Recognizing Infection and When to See a Doctor
While most blisters heal without complication, monitoring the site for signs of infection is important. Signs that the blister may be infected include increased warmth, swelling, or redness extending beyond the immediate area of the wound. The presence of pus, which is a thick, yellowish or greenish discharge, indicates a bacterial infection.
More severe signs, such as red streaks radiating from the blister or the development of a fever or chills, suggest the infection may be spreading systemically and require immediate medical attention. The dressing should be changed at least once daily, or whenever it becomes wet or dirty, to allow for inspection of the wound. Individuals with pre-existing conditions that affect circulation or immune response, such as diabetes, should consult a healthcare provider immediately upon discovering a blister.