About pressure injuries
Several common beliefs about bed sores are mistaken. One is that a small opening means a small wound. Pressure damage is often wider beneath the skin than at the surface, which is why clinicians measure depth and check under the edges.
Another is that rubbing a reddened area helps. Current guidance is to avoid massaging skin that already shows pressure damage. Ring or donut-shaped cushions are also a frequent mistake, because they can concentrate pressure around the edge of the ring. And a sore that does not hurt is not a mild one. Lack of pain may simply mean the person has lost feeling there. When in doubt, ask the treating clinician before trying a home remedy or a new cushion.
How the care plan is built
The first visit starts with a close look at the wound itself. The treating clinician notes exactly where it is, measures its length, width and depth, and checks whether it extends under the skin edges. The type of tissue in the wound bed matters, as does the amount and color of drainage and the condition of the skin around it.
From these findings the clinician assigns a stage, or records that the wound cannot be staged yet because its base is hidden. The same measurements are repeated at later visits. Comparing them over time is how the clinician judges whether the current orders are working or need to change.
Local context: Affton
People in Affton with a pressure injury often move between settings: home, a hospital stay, a few weeks of rehabilitation, then perhaps assisted living or skilled nursing close by. Each move brings a new bed, new caregivers and a risk that the turning plan and wound orders get lost. Gateway arranges wound care in private homes and in senior living and nursing facilities across Affton, and helps the latest measurements and orders travel with the person.
Affton sits just southwest of the St. Louis city limits, an unincorporated South County community that grew up along Gravois Road and Mackenzie Road. Blocks of brick bungalows and modest ranch houses fill the streets between them, and many households have been in the same home for decades. That staying power is the reason care at home matters here. When a wound needs regular attention or a chronic condition needs follow-up, a visit to the house or to a nearby facility spares an older adult the drive, the parking lot and the waiting room.
At home between visits
Many people with a pressure injury at home also have a home health agency involved. When that is the case, the wound orders from the treating clinician need to reach the home health nurse, and the nurse’s observations need to reach the clinician. Gateway helps pass that information in both directions so the family is not left carrying messages.
If no home health agency is in place, tell us who is available to help: a spouse, adult children, a paid aide or no one. The treating clinician can decide whether to order home health nursing, and the plan can be shaped around the help that really exists.
For residents of nursing and senior living communities
People often arrive at a rehabilitation center with a pressure injury that began in the hospital, or with fragile skin after surgery and days in bed. Therapy adds a new question: how long can the person sit in a wheelchair or on a mat without harming the wound? The treating clinician, nursing staff and therapists work that out together.
Rehab stays are short, so planning for what comes next begins early. Gateway can help arrange for wound care to continue after discharge, whether the person goes home or to another facility, so that orders, records and supplies follow them and care does not start over.
What to report and when to call 911
Pressure damage can start before the skin opens. Check the tailbone, hips, heels and other bony areas when you help with bathing or dressing, and tell the treating clinician or nurse if you see:
- A patch that stays red, purple, maroon or darker than nearby skin after the pressure is off
- Skin that feels warmer, cooler, firmer or softer than the skin around it
- A blister, a shiny area or a shallow break
- A spot the person says is sore, burning or itchy
Call 911 if the person has trouble breathing, chest pain, or is suddenly very hard to wake.
Why primary care matters here
Several everyday medical issues affect how much pressure the skin takes. Medications that cause drowsiness can reduce the small movements a person makes while sitting or sleeping. Untreated pain makes people hold still and resist turning. Diarrhea, urinary infections and constipation with leakage keep skin wet. Stiff, contracted joints limit the positions a person can use.
A primary care clinician can review the medication list, pain control, bowel and bladder problems and whether therapy would help with mobility. Do not stop or change a medication on your own. Bring the concern to the clinician, and ask Gateway to share it with the wound care team as well.
Getting care arranged in Affton
For a resident of a nursing home, assisted living or memory care community in Affton, a request for pressure injury care can come from the family, the resident or the facility’s nurses. Call 314-325-0126 and give us the facility name, the unit or room and the best nurse contact. Gateway speaks with the facility about its process for outside clinicians, confirms availability and coordinates a visit time that fits the resident’s day. After the visit, the treating clinician’s orders are given to facility nursing, and the family contact on file gets an update if the resident has agreed to that.
When you call 314-325-0126 about someone in Affton, have the street address, a phone number for the person who will be home, the name of the primary care doctor and any recent discharge papers nearby. Mention stairs, pets or a side-door entrance. Because Affton is compact and close to major roads, visits here can be planned alongside others in Mehlville, Crestwood, Shrewsbury, Webster Groves, South St. Louis and the rest of South County. Availability is confirmed for your address and care setting when you call.
- County: St. Louis County, Missouri
- ZIP codes: 63123
- Nearby hospitals: Mercy Hospital South; SSM Health St. Mary's Hospital in Richmond Heights; St. Luke's Des Peres Hospital (not affiliated with Gateway)
- Nearby communities: Mehlville, South County, Webster Groves, Crestwood, South St. Louis, Shrewsbury
- Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation
Related care in Affton
Read the full guide to pressure injuries, or see everything Gateway arranges on the mobile wound care in Affton page.
- Diabetic foot ulcers
- Venous leg ulcers
- Arterial and mixed wounds
- Non-healing wounds
- Post-surgical wounds
- Reopened (dehisced) surgical wounds
- Surgical site infections
- Skin tears and traumatic wounds
- Wounds with lymphedema
- Skin graft aftercare
- Wound VAC (NPWT) follow-up
- Pressure injury and bed sore care in Mehlville
- Pressure injury and bed sore care in South County
- Pressure injury and bed sore care in Webster Groves
- Pressure injury and bed sore care in South St. Louis
Common questions
Does Gateway work with nursing homes and assisted living communities in Affton?
Yes. Gateway arranges for partner clinicians to see residents with pressure injuries in skilled nursing, assisted living, memory care and rehabilitation settings, either one resident at a time or through regular wound rounds. Facility staff can refer a resident, and families can ask the facility to contact us. Availability for a specific building is confirmed when the request comes in.
What should we have ready before the first wound care visit?
Have a current medication list, any hospital or rehab discharge papers, the insurance cards and the dressings you are using now. Write down when the sore was first noticed and how it has changed. Jot down your questions too, including who to call between visits. If several people share caregiving, try to have the main helper present to hear the plan.
How quickly can a pressure injury develop?
Faster than most families expect. In a person who is very frail or cannot move, damage can begin within hours of unrelieved pressure, for example during a long wait on a hard stretcher, a lengthy surgery or a day spent in one chair. That is why any new discoloration over a bone after a hospital visit, a procedure or an illness deserves a prompt call to the treating clinician.
My father is coming home to Affton from Mercy Hospital South. What should we do first?
Call 314-325-0126 as soon as you know the discharge date, or ask the hospital case manager to fax a referral to 314-786-7966. Keep the discharge paperwork, the medication list and any wound care instructions together. Gateway requests the records, confirms availability at his address and arranges follow-up with a treating clinician. If he has severe bleeding, chest pain or trouble breathing, call 911.
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.