Burn Wound Follow-Up Care in St. Louis

Where burn wound follow-up care fits

Burn wound follow-up care is what comes after a burn or scald has been evaluated and first treated, usually in an urgent care, an emergency department or a burn center. It covers the dressing changes, wound checks and questions that come up while the skin heals.

That is the part Gateway helps arrange, with partner clinicians who can follow a healing burn at home or in a facility across Greater St. Louis and the Metro East. Gateway is not an emergency service.

Gateway arranges care for this kind of wound across the region. See wound care in St. Louis for how visits at home and in facilities are set up.

Burns that need emergency care, not a home visit

Call 911 or go to an emergency department for:

A burn that looks white, leathery, waxy or charred, or that has little feeling
A blistered burn larger than the palm of the injured person’s hand
Burns on the face, hands, feet or genitals, or over a major joint
A burn that goes all the way around an arm, leg, finger or toe
Chemical or electrical burns
Burns with smoke exposure, coughing, a hoarse voice or trouble breathing
Any significant burn in an infant, a young child or a frail older adult

If you are not sure how serious a burn is, have it seen in person right away.

How burns and scalds heal

A scald is a burn from hot liquid or steam, such as spilled coffee or bath water that is too hot. What matters most for healing is how deep the injury goes.

Superficial burns affect the top layer of skin. They are red and sore, like a sunburn, and do not blister.
Partial-thickness burns reach the second layer. They blister, weep and are often very painful.
Full-thickness burns go through the skin. They can look white, brown or black and may not hurt, because nerve endings are damaged.

Deeper burns are sometimes treated with surgery and a skin graft, and Gateway also coordinates skin graft aftercare.

Who tends to need closer follow-up

Some burns heal slowly even when they are small. Older adults have thinner skin, so the same hot water causes a deeper injury. Diabetes, poor circulation and leg swelling slow repair, especially on the lower legs and feet.

Loss of feeling is another risk. People with numb feet can be burned by a heating pad or a hot foot soak and not know it until they see the blister. Our page on neuropathic foot ulcers explains why.

What a burn follow-up visit covers

A follow-up visit with the treating clinician usually includes:

Measuring the burn and noting how its depth and color are changing
Deciding how to manage blisters and loose or dead tissue
Checking for infection
Choosing dressings that protect new skin and come off with less pain
Checking movement when a burn crosses a joint, since healing skin can tighten

Orders from the emergency department or burn center stay in effect unless a clinician changes them. Gateway requests those records, arranges supplies and helps set up dressing changes according to the orders. If dressing changes hurt, say so. Pain and comfort are part of the plan.

Changes to report between visits

Contact the treating clinician promptly if you notice:

Redness spreading out from the burn, or new warmth and swelling
Cloudy, green or foul-smelling drainage, or other signs of wound infection
Increasing pain
Fever or chills
The burn turning darker, deeper or larger
A dressing that is stuck, soaked through or has slipped off

Call 911 for trouble breathing, confusion, fainting, or a high fever with rapidly spreading redness.

Skin care after a burn has closed

New skin over a burn is thin and dry at first. It often itches, may look pink, purple or darker than the skin around it, and burns easily in the sun. Scratching can break it open again.

Ask your clinician which moisturizer to use and how to protect the area from the sun. Our guides on itching around a healing wound and on scars and skin after a wound heals cover what to ask.

How to arrange burn follow-up through Gateway

Patients, family members and caregivers can call 314-325-0126, with or without a referral, or request care through a short form that asks only for a name and phone number.

Have the discharge paperwork nearby. Availability depends on your location and care setting, and benefits depend on the treating provider, your plan and the care the burn needs.

Common questions

Should I pop a burn blister?

No, do not open it yourself. An intact blister covers the raw skin underneath, and opening it at home can let bacteria in. Whether to leave a blister alone or open it is a decision for the clinician who examines it. If one breaks on its own, cover the area with a clean dressing and let the treating clinician know.

Can a burn get worse after the first day?

Yes. Burned tissue keeps changing for several days, so a burn that looked shallow at first can turn out to be deeper. A pale or dark center, more swelling or loss of feeling are reasons to have it looked at again. This is why emergency departments often ask people to return for a recheck.

Do I still need burn center appointments if I have visits at home?

Yes. Keep them unless the burn team tells you otherwise. Follow-up arranged through Gateway does not replace the burn center or surgeon. It adds wound checks between those appointments. Gateway helps get visit notes to the burn team so that everyone works from the same plan.

Can I call about a burn that no one has examined yet?

You can call, and we will explain what the treating clinician would need. But Gateway is not an emergency service and cannot promise how soon a visit can happen. A new burn that is blistered, deep, large, or on the face, hands, feet or genitals should be seen at an urgent care or emergency department first.

General information to help you talk with your own clinician. It is not medical advice, and the treating clinician makes every clinical decision. For a medical emergency, call 911.

Burn wound follow-up care for healing burns and scalds.