Heel and ankle pressure injuries are a common but preventable complication of surgery (Whittington and Briones, 2004). Approximately 25% of pressure injuries begin in the operating theatre (Bliss and Simini, 1999), that is, the deep tissue injury is incurred at the time of surgery, with some authors quoting incidence rates of up to 66% for patients with a fractured hip (Versluysen, 1986). The cost to the community is very high, and the cost to the American healthcare system for pressure injuries of the foot and ankle that develop in the operating theatre is around $US900 million (£592 million; Bliss and Simini, 1999; Whittington and Briones, 2004; Zulkowski et al, 2005; Vanderwee et al, 2007). In Australia the figure is approximately $AU84 million (£54.143 million; Australian Institute of Health and Welfare, 2008). In the UK, the cost of treating pressure ulcers totals up to £2.1 billion, which represents 4% of the total NHS expenditure (Bennett et al, 2004) Twenty five percent of all pressure injuries occur on the heel and a further 8% occur on the lateral malleolus, making a total of 33% of all pressure injuries occurring on the foot (Whittington and Briones, 2004; Vanderwee et al, 2007).