Patent Publication Number: US-7909787-B2

Title: Reconfigurable heel elevator

Description:
This application claims the benefit of US Provisional Application No. 60/730,766, filed Oct. 27, 2005, which is incorporated herein by reference in its entirety. 
    
    
     BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     The present invention relates generally to preventing, treating, and/or relieving decubitus ulcers and, more particularly, to a device that reduces or eliminates heel pressure while the leg is extended, and that allows for and does not impede ambulation while the device is in place. 
     2. Background Information 
     Because of its thin layer of subcutaneous tissue between the skin and bone, the heel is the second most common site for pressure ulcer development (after the sacrum). Heel ulcers are costly and, if not treated promptly and properly, may lead to osteomyelitis and even limb amputation. Pressure ulcers of the heel may occur in individuals who for any reason spend extended periods of time in bed, and/or who may suffer from certain diseases or ailments making them prone to ulcers even without extended bedrest. For instance, heel ulcers often occur in patients with immobile legs due to health care problems such as fractured hips, joint replacement surgery, spinal cord injury, Guillain-Barré syndrome, or stroke, who do not move their legs because of paralysis, weakness, or pain. Diabetic patients are also susceptible to heel ulcers, as these patients may not feel foot pressure or injuries because of peripheral neuropathy, increasing the likelihood for heel ulcers even without extended bedrest or leg elevation. Further, immobile diabetic patients may have trouble moving their legs, thus exacerbating the decubitus conditions that cause heel ulcers. Patients who have leg spasms, or who are otherwise confused, may rub their heels on the bed and abrade the heel. Patients may also dig their heels into the mattress to keep from sliding down in bed, causing further pressure injury. 
     Effective heel ulcer treatment and prevention involves reducing pressure, friction, and shear on the heel; separating and protecting the ankles; maintaining heel pressure reduction or suspension; and preventing footdrop, even under patient movement. The apparatus should also be comfortable for the patient, easy for the caretakers to use, and permit repositioning without increasing pressure in other areas. While there are quite a few devices and techniques currently being used, none of them are able to adequately address these and other considerations for effective heel ulcer treatment and prevention. 
     One bedside technique widely used by caretakers is positioning a pillow, rolled towel, or folded bath blanket under the lower leg region to elevate or suspend the foot off the bed to avoid contact of the heel with the bed. In this case, the towel should be placed under the calf and not under the Achilles tendon, as using a rolled towel under the Achilles tendon to lift the leg for more than a day or two may injure the Achilles tendon. Improper positioning and/or excessive height of such improvised elevating devices may hyper-extend the knee. Such improvised bedside techniques, therefore, are evidently not well controlled, and may not only be ineffective in preventing heel pressure, but also may lead to other injuries. 
     Numerous leg elevating products are marketed that act like special-purpose pillows or cushions upon which the leg and/or foot rests. Such products may be well suited for patients with immobile legs, such as those recovering from hip and knee surgery or stroke. Because these devices generally are not securely attached to the patient, they typically do not adequately protect the patient&#39;s heel from pressure, abrasion, and/or shear as the patient moves or changes body position. Accordingly, if the patient is at risk for moving her leg off the device, or if her leg needs to be elevated longer than a few days, then it may be better to use a product that stays on the foot during movement. 
     Many heel protection devices that are attachable to the leg and/or foot are marketed. Although such a device may be selected for use on patients who are able to move their leg and who thus may be able to ambulate, typically the device itself prevents or otherwise impedes ambulation, and generally must be entirely removed for ambulation, and then repositioned and reattached when the patient returns to the bed. Additionally, many of these devices encase or enclose the heel, thus not providing for the elimination of heel pressure, and not providing much advantage other devices and techniques for preventing heel abrasion by reducing friction from shearing and rubbing, such as various moisturizers, socks, and dressings (such as films or hydrocolloids). 
     Therefore, in view of the background information presented hereinabove, the need is manifest for advances in decubitus ulcer prevention and treatment, and particularly for the prevention and treatment of heel ulcers. 
     SUMMARY OF THE INVENTION 
     Various embodiments of the present invention provide such advancements and overcome the above mentioned and other problems and limitations of the background art, by providing a method and apparatus for eliminating or otherwise reducing or mitigating pressure on an individual&#39;s heel while the leg is in an extended position, while allowing for ambulation without completely removing the device. 
     In accordance with an aspect of the present invention, an apparatus comprises a support member configured to be attached to a lower leg portion of an individual between the calf and heel region, the support member having an inner surface portion to be disposed facing the leg when attached thereto, and having an opposite outer surface; and a reconfigurable elevation member configured (i) to be disposed at the outer surface of the support member such that when the support member is attached to the lower leg portion of the individual the elevation member is selectively capable of providing elevation of the heel from an underlying surface in the event that the lower leg portion is extended above the underlying surface, and (ii) to be reconfigured for ambulation without removing said support member from the lower leg. 
     In accordance with another aspect of the present invention, the reconfigurable elevation member may include an inflatable and deflatable bladder integral with the support member. The reconfigurable elevation member may be reconfigured for ambulation by deflating the bladder. The inflatable bladder may be apportioned into a plurality of pneumatically coupled regions separated by at least one baffle. The support member may include an adhesive portion for attachment to the lower leg. 
     In accordance with a further aspect of the present invention, the support member includes opposing lateral portions disposed adjacent to opposite lateral sides of the lower leg relative to the saggital plane, and further comprising for each lateral portion at least one lateral cushion member removably attachable to or integral to the lateral portion. At least one lateral cushion member may be inflatable and deflatable. 
     In some implementations, the support member may comprise a semi-rigid plastic spine and a foam member attached to the inner surface of the support member, and wherein the inflatable and deflatable bladder is disposed at the outer surface of the semi-rigid plastic spine. 
     In accordance with still other embodiments of the present invention, an apparatus comprises a support member configured to be attached to a lower leg portion of an individual between the calf and heel region, the support member having an inner surface portion to be disposed facing the leg when attached thereto, and having an opposite outer surface; and a reconfigurable elevation member that is removable attachable to the support member and is configured (i) to be disposed at the outer surface of the support member such that when the support member is attached to the lower leg portion of the individual the elevation member is selectively capable of providing elevation of the heel from an underlying surface in the event that the lower leg portion is extended above the underlying surface, and (ii) to be reconfigured for ambulation without removing said support member from the lower leg. Upon detaching the reconfigurable elevation member from the support member for ambulation, the apparatus does not impede ambulation. 
     In accordance with some aspects of such other embodiments, the reconfigurable elevation member includes a cushion member that, upon attaching the reconfigurable elevation member to the support member, is disposed at the outer surface of the support member such that when the support member is attached to the lower leg portion of the individual, the cushion member provides elevation of the heel from an underlying surface in the event that the lower leg portion is extended above the underlying surface. The cushion member may provide elevation of the heel sufficient to spatially separate the heel from the underlying surface. The cushion member may be implemented as at least one of a fluid filled member that is not adapted for deflation, and a preformed cushion member that is not adapted for deflation. 
     In accordance with other aspects of such other embodiments, the reconfigurable elevation member includes at least one inflatable and deflatable bladder that, upon attaching the reconfigurable elevation member to the support member, is disposed at the outer surface of the support member such that when the support member is attached to the lower leg portion of the individual, the bladder provides for adjustable elevation of the heel from an underlying surface in the event that the lower leg portion is extended above the underlying surface, and wherein the bladder is inflatable by a predetermined fluid. The predetermined fluid may be air or other gaseous, liquid, gel, or other fluid-like material. 
     In accordance with some aspects of such embodiments, the inflatable and deflatable bladder may be apportioned into a plurality of pneumatically coupled regions separated by at least one baffle. The pneumatically coupled regions may include a plurality of lateral baffle portions configured to be disposed adjacent to opposite lateral sides of the lower leg relative to the saggital plane upon attaching the inflatable bladder to the support member. 
     In accordance with some implementations, the reconfigurable elevation member is removably attachable to the support member by a hook and loop fastener, such as Velcro® brand Hook and Loop Fasteners available from Velcro USA Inc. located in Manchester New Hampshire. Additionally, the support member may comprise a backing layer material and a foam member attached to the inner surface of the backing layer material. 
     In accordance with still other aspects of the present invention, methods are provided for preventing or treating heel ulcers or otherwise mitigating or eliminating heel pressure by attaching the support member to an individual&#39;s lower leg at the calf area just above the ankle, and inflating a bladder integral to the support member. When the patient is in a supine position, the bladder assembly is in contact with the surface of the bed and elevates the heel thereby eliminating the contact of the heel with the surface of the bed. When the patient needs to move around, the bladder can be deflated. 
     In accordance with still other aspects of the present invention, methods are provided for preventing or treating heel ulcers or otherwise mitigating or eliminating heel pressure by attaching a support member to an individual&#39;s lower leg at the calf area just above the ankle, and attaching a removably attachable cushioning member thereto. The cushioning member may be inflatable and deflatable, in which case the cushioning member is inflated before or after attachment to the support member. When the patient is in a supine position, the bladder assembly is in contact with the surface of the bed and elevates the heel thereby eliminating the contact of the heel with the surface of the bed. When the patient needs to move around, the cushion member can be detached. The cushion member can be reattached again if required. The cushion may comprise a bladder assembly including three air filled bladders made of PVC and joined at the sides. Hook and loop fasteners may be used to attach the bladder assembly to the support member. 
     It will be appreciated by those skilled in the art that the foregoing brief description and the following detailed description are exemplary and explanatory of this invention, but are not intended to be restrictive thereof or limiting of the advantages which can be achieved by this invention. Thus, the accompanying drawings, referred to herein and constituting a part hereof, illustrate preferred embodiments of this invention, and, together with the detailed description, serve to explain the principles of this invention. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Additional aspects, features, and advantages of the invention, both as to its structure and operation, will be understood and will become more readily apparent when the invention is considered in the light of the following description made in conjunction with the accompanying drawings, wherein: 
         FIGS. 1A and 1B  illustrate isometric views of a heel elevation device, in accordance with an embodiment of the present invention; 
         FIG. 2  schematically depicts a side view of the heel elevation device of  FIGS. 1A and 1B  attached to an individual&#39;s leg, in accordance with an embodiment of the present invention; 
         FIG. 3  schematically depicts a side view of a heel elevation device attached to an individual&#39;s leg, in accordance with another embodiment of the present invention; 
         FIGS. 4 and 5  respectively depict plan views of an illustrative support member and removably attachable elevation member comprising a heel elevation device, in accordance with another embodiment of the present invention; and 
         FIGS. 6  schematically depict a side view of the heel elevation device of  FIGS. 4 and 5  attached to an individual&#39;s leg, in accordance with an embodiment of the present invention. 
     
    
    
     DETAILED DESCRIPTION OF EMBODIMENTS OF THE INVENTION 
     As will be understood and more fully appreciated from the ensuing description, embodiments of the present invention are configured for attachment to the lower leg to provide for reducing or eliminating pressure on the heel region of the foot when the leg or foot is positioned such that the heel is in contact with an underlying surface (e.g., a bed) or would be in contact with an underlying surface but for the presence of the device. That is, as will be further understood below, while embodiments of the present invention may be implemented to sufficiently elevate the foot to provide for spatial separation of the heel from an underlying surface that the heel would otherwise rest upon, such and other embodiments of the present invention need not be used to provide such spatial separation of the heel, but rather may be advantageously used to reduce pressure on the heel even if the heel is in contact with an underlying surface. Additionally, even when the foot may be cantilevered over the end of a bed or other supporting structure, embodiments of the present invention may be used to provide cantilever elevation and support, and to prevent or otherwise reduce pressure on the heel region as the individual moves while the heel is originally in a cantilevered position. Further, while embodiments of the present invention are securely attached to the individual to ensure proper operation of the device, these devices are easily reconfigurable at the bedside to allow the individual to ambulate without being impeded by the device. 
     In accordance with an illustrative embodiment of the present invention,  FIGS. 1A and 1B  depict perspective views of a reconfigurable heel elevator implemented as an inflatable/deflatable heel elevation device  10  comprising backing or spine  12 , extensions  14   a  and  14   b , peelable barriers  16   a  and  16   b , foam layer  18 , inflatable bladder  20 , lumen or tube  22 , and valve  22 . In this illustrative embodiment, backing/spine  12  is made of plastic and is semi-rigid, being contoured to conform to the shape of the lower leg between the calf and ankle region, having a concave inner (i.e., leg-facing) surface and being laterally wider towards the upper part of the leg (the proximal end) and tapering towards the lower part of the leg (the distal end). In some embodiments, backing/spline  12  may be made of various materials (e.g., plastic, polymer, rubber, resin, fabric, etc.) with varying degrees of flexibility; for instance, backing/spline  12  may alternatively be made of neoprene or similar material that is flexible or bendable by hand such that backing/spine  12  may be wrapped around or otherwise conformed to the lower leg region of the patient. 
     According to the embodiment depicted in  FIGS. 1A and 1B , two extensions  14   a  and  14   b  made of a flexible material, such as polyurethane/PVC, extend from the lateral edges of backing/spine  12 . Extensions  14   a  and  14   b  may be integrally formed with backing/spine  12 , or may otherwise be attached thereto. The inner (i.e., leg-facing) surfaces of extensions  14   a  and  14   b  include an adhesive, which is covered by peelable barriers  16   a  and  16   b . The adhesive may be any of various well-known medical adhesives for adhering to the skin (e.g., acrylic polymer), and in some embodiments the construction and technology of the extensions  14   a  and  14   b , the adhesive, and peelable barriers  16   a  and  16   b  may be similar to that of adhesive bandages or protective strips. 
     A thin foam layer  18  (e.g., one-quarter inch foam) is attached to, and contoured in conformity with, the inner surface (i.e., leg facing, concave surface) of backing/spine  12 . In this embodiment, foam layer  18  is provided for additional patient comfort and improved comformity to the leg, as opposed to having semi-rigid backing/spine  12  contact the leg directly. In alternative implementations, such as embodiments employing a softer and/or flexible backing, foam layer  18  may be eliminated, and the backing material may directly contact the leg. Additionally, as further discussed hereinbelow, it is understood that elevation device  10  may be implemented in a variety of configurations, and may be secured to an individual&#39;s leg by any of a variety of fastening mechanisms that may be employed in addition, or as an alternative, to an adhesive. 
     As depicted in  FIG. 1A , inflatable bladder  20  (shown in the deflated state) is attached to the outer surface (facing away from the leg when in place) of backing/spine  18 , and may be made of polyurethane or other plastic or polymer material. In some embodiments, rather than bladder  20  being an inflatable closed surface that is attached to backing/spine  18 , the outer surface of backing/spine  18  may form part of the inner, air-containing surface of bladder  20 . Bladder  20  has a valve  24  through which air can be pumped to inflate the bladder, and, in this embodiment, valve  24  is coupled to bladder  20  via a lumen or tube  22 , which is also attached to the outer surface of backing/spine  18 . As will be appreciated, valve  24  may be positioned at any location on or relative to bladder  20 , and in this embodiment valve  24  is positioned laterally (by means of tube  22 ) and proximally such that the valve is easily accessible for inflation/deflation and does not impede or interfere with the patient, create a pressure point, or otherwise cause patient discomfort. A manually operated squeeze bulb, electrically powered mechanical pump, or other source of compressed air may be used to inflate bladder  20 . Valve  24  may be a self-sealing, pressure-type valve that automatically seals upon removal of inflation pressure, and may additionally or alternatively provide for deflation without attaching a pumping mechanism for evacuation. In some embodiments, bladder  20  may be implemented for filling or inflation with a fluid other than other than air. 
     Bladder  20  may be formed and dimensioned to provide a desired profile and volumetric shape when inflated. For instance, in the embodiment shown in  FIG. 1A , the outer contour of bladder  20  along the surface of backing/spine  18  has a generally trapezoidal shape that is similar to the generally trapezoidal shape of backing/spine  18 . Additionally, in this embodiment, bladder  20  is formed such that upon inflation the displacement between the outer surface of the bladder and the outer surface of backing/spine  18  in a direction normal to the outer surface of backing/spine  18  monotonically increases from the proximal end (end near the calf when in position) to the distal end (end near the heel when in position). 
     Such a profile is shown in  FIG. 2 , which depicts a side view of heel elevation device  10  attached to a patient&#39;s leg. As may be understood from this side view, the cross sectional profile in the sagittal plane has a generally trapezoidal, tapered shape that generally complements the contour of the adjacent rear leg portion such that the outer surface (posterior surface) of bladder  20  is generally parallel to the shin. Also, as embodied, the maximum displacement between the outer and inner surfaces of the bladder (i.e., when the bladder is fully inflated) is great enough to sufficiently elevate the patients heel such that the heel is spaced away from an underlying surface  29  (e.g., a bed), which surface the patient&#39;s heel would rest upon but for the elevation provided by heel elevation device  10 . By way of example, such maximum displacement may be about two to three inches. It is understood, however, that even if the patient&#39;s heel or foot is cantilevered off the edge of an underlying surface (e.g., bed), heel elevation device  10  is still useful for preventing, for example, possible abrasions or shear, possible digging of the heels in the bed, heel pressure in the event the patient moves such that the foot or leg is no longer cantilevered, as well as for reducing or preventing pressure on the Achilles tendon and/or reducing or preventing other concentrated pressure that may affect circulation. 
     An illustrative technique for applying and using inflatable/deflatable heel elevation device  10  is as follows. Heel elevation device  10  may be positioned near and/or against the patient&#39;s lower leg, between the calf and ankle region. Then, peelable barriers  16   a  and  16   b  are peeled away to expose the underlying adhesive on the inner surfaces of extensions  14   a  and  14   b , which are then pressed against the patient&#39;s leg, thus adhering heel elevation device  10  to the patient&#39;s leg (with foam layer  18  against the patient&#39;s leg). Then, in the case that the patient is or will be in a supine position or other position where the patient&#39;s leg is extended so as to rest upon an underlying surface, and in the case that the case that bladder  20  is in a deflated state, or additional inflation is otherwise desired, bladder  20  is inflated to a desired level of inflation (e.g., inflation pressure) to provide the desired heel elevation, cushioning/firmness, and/or stability. As will be appreciated, the elevation height may be adjustable, based on the volume (and hence pressure) of air pumped into the bladder. In the event that the patient intends to ambulate, bladder  20  may be deflated to avoid, for example, rubbing of the bladder against the other leg (e.g., the occurrence and amount of which depends on the particular design of the bladder(s)), or any other inconvenience, impediment, or awkwardness in ambulation. 
     In this illustrative embodiment, the semi-rigidity of backing/spline  12  may also prevent or mitigate excessive inward pressure against the back of the leg as the bladder is inflated, which pressure could affect circulation, or excessively strain the adhesive coupling to the leg (e.g., causing discomfort, or possibly causing the extensions to peel away from the leg). Such prevention or mitigation of inward pressure may alternatively or additionally be accomplished by the design of the bladder itself (e.g., designing the bladder wall material and/or configuration such that it inflates predominantly or entirely outwardly in the posterior direction). It is understood, however, that such prevention or mitigation of inward pressure is not a necessary feature for implementing embodiments of the present invention. In some embodiments, at least a certain degree of inward inflation is advantageous for distributing the pressure over the back of the leg, conforming to the leg, and/or providing stable support (e.g., lateral support) for elevating the heel and reducing heel pressure. 
     In some embodiments, the outer surface of either or each extension piece  14   a  and  14   b  may be implemented with an integrally formed and/or irremovably attached inflatable/deflatable bladder, as may be desirable to further prevent and/or mitigate heel pressure, friction or shearing, by providing additional lateral support, cushioning and elevation (e.g., in the case the patient lies on his side). These bladders may be pneumatically isolated from bladder  20 , and may have separate valves for individual inflation/deflation, or may be pneumatically coupled to each other (e.g., by a tube) such that they may be inflated/deflated through a common valve. One or both of these bladders may be inflated when the leg is extended (e.g., the patient is in the supine position), and one (e.g., the bladder on the instep side of the sagittal plane; i.e., the one facing the opposing leg) or both may be deflated for ambulation. In some embodiments, bladder  20  may be configured such that it does not impede ambulation even if inflated (e.g., the lateral extent of bladder  20  is limited), and thus only one or both of the lateral bladders may be deflated for ambulation. In alternative embodiments, the lateral bladders may be removably attachable (e.g., by hook and loop fasteners, snaps, etc.) to extensions  14   a  and  14   b , and, as such, need not be inflatable/deflatable, but may, for example, be implemented as preformed and/or prefilled (e.g., air or other fluid) cushioning member. 
     In still other embodiments, rather than using an inflatable/deflatable bladder  20  at the bottom, outer surface of the heel elevation device, an uninflatable/undeflatable cushioning/elevation member (e.g., foam, or a fluid filled cushion) may be used, provided it provides sufficient elevation for mitigating and/or eliminating heel pressure, and is configured such that it does not impede ambulation. In such embodiments, lateral bladders (e.g., (i) removable and inflatable/deflatable or not inflatable/deflatable, or (ii) integral/fixed and inflatable/deflatable) are advantageously included to provide additional lateral support and stability, as the bottom bladder generally will require a narrower lateral extent to avoid impeding ambulation. As noted above, in the case that these lateral bladders are removable, it is not necessary that they be deflatable; for instance, they may be implemented using any of a variety of cushioning materials (e.g., foam), including air, gel, or other fluid filled cushions. It is noted, however, that inflatable/deflatable bladders (e.g., for the bottom/posterior cushioning member as well as for the lateral cushioning members) are well suited for providing adjustability of elevation and cushioning/firmness, as well as for evenly distributing/redistributing pressure and conforming to the patients leg, even under dynamic load conditions (e.g., resulting from patient movements that may change the load conditions). 
     As understood and indicated by the foregoing description of illustrative embodiments and variations thereof, cushioning members (posterior and/or lateral) may have a variety of shapes or profiles. For instance, in the deflated state, various embodiments of posterior bladder  20  may have a generally triangular (e.g., isosceles triangle) or generally trapezoidal (e.g., isosceles trapezoid) shape in the lateral plane (e.g., when the heel elevation device  10  is laid flat on a planar surface), with the base or wider base portion being disposed such that it will be proximal to the knee when the heel elevation device is attached to an individual&#39;s leg. Such a triangular or trapezoidal deflated bladder is configured such that upon inflation the bladder will have a generally conical shape, with the narrower apex of the conical bladder being towards the top of the leg (i.e., the proximal end of the bladder relative to the knee), and the wider base of the conical bladder being toward the bottom of the leg (i.e., the distal end relative to the knee; proximal to the ankle/heel), such that the fluid filled (e.g., air-filled) cross sectional area increases from the calf towards the heel. 
     It may also be understood that in some embodiments, more than one separately inflatable posterior bladder may be provided along the length (longitudinally) between the proximal and distal ends. The cross sectional elevation profile in the sagittal plane (i.e., elevation along the longitudinal direction) may thus be adjusted by separately adjusting the pressure of each posterior bladder provided. Alternatively, or additionally, a bladder may be apportioned into multiple sections that are commonly inflated, but have different shapes or contain different volumes of fluid when the bladder is inflated. For instance, bladder  20  may be adapted to include multiple longitudinal and/or lateral sections by, for example, separating the sections with baffles that may be formed by heat sealing the outer surface of the bladder to the inner surface (e.g., the backing/spline side) along most of the extent dividing adjacent sections, but leaving an opening between adjacent sections such that fluid (air) can flow therethrough. Accordingly, upon inflation, each of the sections will be filled, but the shape/profile of each section may be determined by the baffle configuration/shape and the fluid containing volume of each section separated by the baffles. 
     As yet a further illustrative example of variations within the purview of the present invention, more than one separately inflatable bladder may be provided in the posterior direction to allow variable height adjustment and cushioning pressure by selectively filling one or more bladders.  FIG. 3  schematically depicts a side view of an illustrative embodiment of a heel elevation device implementing such a variation, and having two separately inflatable/deflatable bladders  20  and  23 . (For ease of reference, components similar to those in  FIG. 2  are labeled with identical reference numerals). As depicted, while the first bladder  20  may have a generally trapezoidal cross-section (as in the embodiment of  FIG. 2 ), a second bladder  23  may have a uniform cross sectional thickness in the sagittal plane. More specifically, in  FIG. 3 , a first bladder attached to the plastic spline when fully inflated may provide an air cushion thickness of up to about 2 inches, and a second bladder attached to the outer side of the first may also provide an air cushion thickness of up to about 2 inches when fully inflated, thus together providing for up to about 4 inches of adjustable elevation. The inner and outer bladders may be appropriately shaped, for instance, such that the anterior bladder (i.e., bladder  20 ) conforms to the rear of the leg, while the posterior bladder (bladder  23 ) provides additional elevation. In this embodiment, a separate valve (and tube/lumen) is provided for inflating/deflating bladder  23 ; however, it is not visible in  FIG. 3 , as it is symmetrically located with respect to the sagittal plane (i.e., it is laterally displaced from valve  24 , on the opposite outer sidewall of extension. 
     In the foregoing illustrative embodiments, heel elevation device  10  is implemented such that the posterior elevation member (e.g., bladder  20 ) is an integral part of, or otherwise not removable from, the portion of heel elevation device that attaches to the patient. That is, once heel elevation device  10  is attached or applied to the patient, the elevation member cannot be removed from the patient without removing heel elevation device  10  itself from the patient. In accordance with further embodiments of the present invention, a heel elevation member that is disposed between the calf and heel region at the back of the leg is removably attachable to a support member that is attachable to the patient. As such, the support member may be securely attached to the patient&#39;s leg. The elevation member may be attached to the support member when the patient will be in a position requiring heel pressure mitigation or elimination, and may be removed from the support member when the patient will undergo ambulation; however, the support member may remain securely in place on the patient&#39;s leg, allowing for the elevation member to be readily attached whenever needed. 
       FIGS. 4 and 5  respectively depict plan views of an illustrative support member  50  and elevation member  60  comprising a heel elevation device in accordance with an embodiment of the present invention. As shown, in this embodiment, support member  50  includes backing  51  and foam member  52 . Backing  51  may be made of PVC (polyvinyl chloride) or any bendable and/or elastic material (e.g., plastic, polymer, rubber, resin, neoprene, fabric, etc.) that may be wrapped about and fastened by various means to an individual&#39;s leg, while allowing elevation member  60  to be removably attached thereto. In this embodiment, similar to the embodiment of  FIGS. 1-3 , backing  51  includes lateral extensions  51   a  and  51   b  having a medical adhesive applied to the inner (leg facing) surface thereof and covered by peelable barriers (not shown), so that support member  50  may be attached to an individual&#39;s leg by removing the peelable barriers and adhering extensions  51   a  and  51   b  to opposing lateral sides of the leg between the calf and ankle region. As further discussed hereinbelow, it is understood that a support member may be implemented in a variety of configurations, and may be secured to an individual&#39;s leg by any of a variety of fastening mechanisms that may be employed in addition, or as an alternative, to an adhesive. 
     Foam member  52  is fixably attached (e.g., by adhesive) to the inner side (leg-facing side) of support member  50 , and is generally contoured to conform to the human leg when the support member  50  is attached thereto. More specifically, in this embodiment, foam member  52  has a generally trapezoidal shape, the wider base portion  52   a  being the portion to be positioned toward the calf (proximal to the knee), and the narrower base portion  52   b  being the portion to be positioned toward the heel/ankle (distal relative to the knee). By way of example, the approximate length (i.e., distance along the longitudinal direction, between base portions  52   a  and  52   b ) of foam member  52  may be about 5 inches, and the width (lateral distance) of base portions  52   a  and  52   b  may be about 6 inches and 4 inches, respectively. As shown, in this embodiment, foam member  52  includes to openings or slits  52   c  and  52   d , which are provided to facilitate conformally fitting support member  50  about the leg. Foam member  52  is thus configured to conform, and be in contact, with the back part of the lower leg between the calf and just above the heel, with extensions  51   a  and  51   b  adhering to either side of the calf and holding support member  50  in place. 
     Referring to  FIG. 5 , in this embodiment, bladder  60  comprises three sections, namely, lateral bladder sections  60   a  and  60   b , and central bladder section  60   c , which are together inflatable/deflatable through common valve  62 . More specifically, bladder  60  is formed as an enclosed, inflatable member, including an inner surface (leg-facing surface, shown in the plan view) and an opposite outer surface (not shown), and may be made from any of a variety of materials (e.g., plastic, rubber, etc.) which may have any of varying degrees of elasticity depending on the design. As shown, attached to the inner surface of bladder sections  60   a ,  60   b ,  60   c  are hook and loop fastener segments  63   a ,  63   b ,  63   c , which are positioned to selectively engage complementary hook and loop fastener segments (not shown) on the outer surface of backing  51  of support member  50 . 
     In this embodiment, seam/baffle  63  (depicted as a dashed line) joins the inner and outer surfaces of bladder  60 , separating lateral bladder section  60   a  from central bladder section  60   c , except for in regions  60   e  and  60   f  which allow for fluid (air) flow between these two sections. Similarly, seam/baffle  65  (depicted as a dashed line) joins the inner and outer surfaces of bladder  60 , separating lateral bladder section  60   b  from central bladder section  60   c , except for in regions  60   g  and  60   h , which allow for fluid (air) flow between these two sections. As such, upon inflating bladder  60  through valve  62 , all three bladder sections inflate, forming a central generally oblate trapezoidal bladder  60   c , and two generally oblate rectilinear bladders  60   a  and  60   b . Bladder  60  may be inflated before or after attaching it to support member  50 . 
     In this embodiment, in attaching the bladder assembly to the support member, the alignment of the bladder  60  is complementary to foam member  52 , with the inner surfaces of lateral bladder sections  60   a  and  60   b  attaching to the outer surface of backing  51  such that they are attached to or adjacent to lateral extensions  51   a  and  51   b , respectively, with the narrower side of bladder section  60   c  being towards the calf (towards base portion  52   a ) and the wider side being towards the heel (towards base portion  52   b ). The cross sectional shape of bladder  60   c  in the sagittal plane is roughly trapezoidal to complement the longitudinal leg profile between the calf and the ankle/heel. The central bladder  60   c  thus provides elevation at the rear/underside of the leg while the two lateral bladders  60   a  and  60   b  are generally positioned along the sides of the leg.  FIG. 6  schematically depicts a sideview of a patient&#39;s leg while the patient is in a supine or recumbent position, with support member  50  attached to the patient&#39;s leg, and bladder  60  attached to support member  50  to elevate the patient&#39;s heel above a bed surface  70 . 
     The ability to inflate/deflate bladder  60  allows for adjusting the height and cushioning pressure, while also simplifying packaging and shipping of the device. It is understood, however, that because bladder  60  is removably attachable to support  50 , it need not be inflatable/deflatable; for instance, one or more of bladder sections  60   a ,  60   b ,  60   c  may be implemented using any of a variety of preformed and/or prefilled cushioning materials such as foam cushions and/or air, gel, or other fluid filled cushions. Additionally, bladder sections  60   a ,  60   b ,  60   c  need not be integral, but may be separately attachable and removable from support member  50 . 
     The present invention has been illustrated and described with respect to specific embodiments thereof, which embodiments are merely illustrative of the principles of the invention and are not intended to be exclusive or otherwise limiting embodiments. For instance, as noted above with respect to the elevation device  10  illustrated in  FIGS. 1   a ,  1   b , and  2 , and similarly with respect to the support member  50  illustrated in  FIGS. 3 ,  4 ,  5 , these components may be implemented in a variety of configurations, and any of a variety of fastening mechanisms may be employed in addition, or as an alternative, to an adhesive for securing the component to an individual&#39;s leg. For instance, in some alternative implementations, only a first one of the extensions may include a longitudinal adhesive strip, and the other extension may have at least a portion (or straps) having sufficient lateral extent to wrap around the entire circumference of the individual&#39;s leg and overlap the first extension and attach thereto with a fastening mechanism such as hook and loop fasteners, button(s), or straps/loops, etc. Alternatively, such buttons, straps/loops, and/or hook and loop fasteners may be used without any adhesive. 
     In some variations of these embodiments, it may be advantageous to include a strap that attaches to the outer surface of backing  51 , or to the outer surface backing/spline  12  or extensions  14   a  and  14   b , near both sides of the ankle, and extends longitudinally, traversing the instep and bottom of the foot, thus providing additional stability and security against motion relative to the leg. Such a strap may be removably or irremovably attached to backing  51 , backing/spline  12 , or extensions  14   a  and  14   b  at one or both ankle region portions. 
     In yet other alternative implementations, attachment or fastening mechanism between the support member  50  and bladder assembly  60  may be include one or more of buttons, hooks, adhesive, snaps, straps, etc., in addition or as an alternative to hook and loop fasteners. 
     Further, while particular shapes, sizes, and materials have been described for purposes of illustration, it will be recognized that any of a variety of shape or size can be used, and the materials described are not exclusive but merely illustrative. Also, as noted hereinabove, while the bladder shown is inflated with air, it will be appreciated that any other fluid or medium such as liquid or gel can be used. Moreover, as also noted, it will be understood that bladders may be configured to have multiple pneumatically independent and/or pneumatically coupled bladder sections, and may also configured to have various contours or lobulations. Additionally, while particular uses/applications of the invention have been described, it will be appreciated that the invention could be used for other applications that involve preventing contact of a body part with any other surface or with another body part. Furthermore, while this is intended to be a stand alone device, it will be appreciated that the method of using an inflatable or prefilled bladder member can be combined with other preexisting devices, such as Venodyne boots or other Intermittent Pneumatic Compression devices. 
     In view of the foregoing illustrative embodiments and variations thereof, it is also understood that embodiments of the present invention provide various advantages and attendant advantages, though practicing the subject matter of the present invention need not provide one or more of these advantages. Illustrative advantages include, for example, preventing, mitigating, or treating pressure ulcers of the heel while also allowing for ambulation without interference or impediment. Additionally, embodiments of the present invention ensure that the apparatus does not shift or move relative to the patient&#39;s leg. Further, embodiments of the present invention provide for heel pressure mitigation or treatment without requiring a large and/or cumbersome device. 
     Accordingly, although the above description of illustrative embodiments of the present invention, as well as various illustrative modifications and features thereof, provides many specificities, these enabling details should not be construed as limiting the scope of the invention, and it will be readily understood by those persons skilled in the art that the present invention is susceptible to many modifications, adaptations, variations, omissions, additions, and equivalent implementations without departing from this scope and without diminishing its attendant advantages. It is further noted that the terms and expressions have been used as terms of description and not terms of limitation. There is no intention to use the terms or expressions to exclude any equivalents of features shown and described or portions thereof. Additionally, the present invention may be practiced without necessarily providing one or more of the advantages described herein and/or that may be realized in some embodiments thereof. It is therefore intended that the present invention is not limited to the disclosed embodiments but should be defined in accordance with the claims that follow.