About non-healing wounds

Non-healing wound is a description, not a diagnosis. It means a break in the skin that is no longer moving toward closure with the care it has been getting. Clinicians also say chronic wound, stalled wound or hard-to-heal wound, and they mean roughly the same thing.

The label covers many kinds of wounds. A surgical incision that opened along part of its length, a shin scraped on a car door, a sore over the tailbone, an ulcer near the ankle or under the foot can all end up here. What they share is the pattern: nearly the same measurements visit after visit, or a wound that seals over and then breaks down again. Working out which kind of wound it really is comes first, because the right care depends on it.

What an assessment covers

When a wound has not responded to reasonable care, the treating clinician may want more information than an exam can give. Depending on the findings, that can mean a check of blood flow to the leg, blood work, a culture, imaging of the bone beneath the wound, or a small tissue sample to rule out an unusual cause.

Not every wound needs every test. The clinician chooses based on where the wound is, how it looks and how it has behaved. Gateway’s part is practical: we help get the orders to the right lab or imaging service, track the results and see that they reach the clinician before the next decision is made.

Non-healing wound care in Alton

On the Illinois side, the first step for a non-healing wound in Alton is confirming who can see you and under which plan. Illinois Medicaid and Illinois-based Medicare Advantage or commercial plans work differently from Missouri plans, and the treating provider must be able to practice and participate where you live. Gateway checks those points before scheduling. We also request records from Illinois hospitals, wound clinics and home health agencies, since a wound that has been open for months usually has a paper trail on your side of the river.

Alton rises from the Mississippi River in steep hills and bluffs, on the Illinois side upriver from St. Louis. The Clark Bridge connects it to Missouri, and the Great River Road follows the bluffs toward Grafton. It is an old city with brick streets, tall houses and neighborhoods that sit above or below one another. Those hills are part of what people love about Alton, and they are hard on anyone with a leg wound, poor balance or limited strength. Gateway arranges wound care and primary care in the home or facility, so the hills stay outside the door.

Care at home

Many people with a long-standing wound already have a home health agency involved. When that is the case, the partner clinician and the agency nurses work from the same orders. The nurses carry out dressing changes and report measurements, and the clinician adjusts the plan at each visit. Gateway shares visit notes with the agency so both sides see the same picture.

Supplies are the other piece. Running out of the ordered dressing and substituting whatever is in the cabinet is a common way for wounds to slip backward. We help route supply orders through the proper channel and ask about quantities before they run low.

For residents of nursing and senior living communities

Assisted living communities are not set up like nursing homes. Staff may help with medications and bathing but are often limited in the wound care they can provide, so a resident with a stalled wound can fall between services. Dressing changes may depend on a visiting home health nurse, a family member or the resident.

Gateway helps sort out who is doing what. We arrange the partner clinician’s visit to the resident’s apartment, find out what the community’s staff can assist with, and coordinate with any home health agency involved. The resulting plan is written for the help that is really available.

What to report and when to call 911

A wound that has been open a long time can still change quickly, and it is easy to stop noticing it. Tell the treating clinician if you see:

  • Redness spreading outward from the wound edge
  • Drainage soaking through dressings faster than before
  • A new or stronger smell after the wound is cleaned
  • Skin around the wound turning warm, hard or shiny
  • Pain that is climbing instead of settling

Call 911 for heavy bleeding that does not stop with firm pressure, chest pain, trouble breathing, or new confusion with a high fever or shaking chills. Gateway is not an emergency service.

How primary care fits in

Two questions come up with nearly every stalled wound: what is this person eating, and what are they taking? Repair needs protein, calories, fluids and certain vitamins, and many older adults with wounds eat far less than they need. Some medicines, including steroids and drugs that act on the immune system, can slow repair as well.

Neither issue should be handled alone. Do not stop or change a medicine by yourself. A primary care clinician can review the full list with the wound in mind, check weight and labs, and weigh the tradeoffs. Arranging primary care alongside wound care makes that review far more likely to happen.

Primary care at home in Alton →

How to get started in Alton

If you have been managing a wound mostly on your own and are looking for non-healing wound care in Alton, you can call Gateway yourself at 314-325-0126. Tell us what the wound looks like now, what the last clinician said about it and what is getting harder to manage. It helps to know the patient’s insurance and the names of the doctors involved, but do not wait until you have everything. We check whether a partner clinician can see the patient at home or in their facility, and we tell you what we find. The treating clinician takes it from there, and you stay part of the conversation.

Alton has two hospitals of its own, Alton Memorial Hospital and OSF Saint Anthony’s Health Center, and many local hospital stays happen at one or the other. Gateway is not affiliated with either. When someone comes home with a wound that needs follow-up or a changed list of medications, the family can call us to ask about visits. Hospital discharge planners and social workers can refer by phone or by fax at 314-786-7966. We gather the discharge records, coordinate with a partner clinician and keep the patient’s regular doctor informed.

More wound care in Alton

Read the full guide to non-healing wounds, or see everything Gateway arranges on the mobile wound care in Alton page.

Common questions

Can a clinician come to a home in Alton to look at a wound that will not heal?

In many cases, yes. Gateway arranges home visits with partner clinicians across Greater St. Louis and the Metro East, and we confirm availability for your exact address and care setting before scheduling. Call 314-325-0126 or send a request with a name and phone number. You do not need a referral to ask, and a family member can call for you.

Could a wound that will not heal be skin cancer?

Occasionally, yes. Some skin cancers look like a sore that never closes, and a wound that has been open for a very long time can, rarely, change. It is not the usual explanation, but it is one reason clinicians take a second look at wounds that do not respond to care. The treating clinician may take a small tissue sample to check. Ask about it if you are worried.

My wound has been treated for months. What would a new clinician do differently?

A reassessment goes back to the cause instead of continuing the same routine. The treating clinician reviews the history, remeasures the wound and looks for barriers that may have been missed, such as pressure, swelling, poor blood flow or a hidden infection. They may order tests or suggest a specialist. Sometimes the plan changes a great deal, and sometimes only one piece does.

Gateway is based in Missouri. Does it really arrange care in Alton, Illinois?

Yes. Gateway coordinates wound care and primary care across the Metro East as well as Greater St. Louis, and Alton is part of that region. Care is delivered by partner clinicians, and availability is confirmed for each Illinois location and care setting. Call 314-325-0126 and tell us the address and where the patient is living.

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.