About wound VAC therapy
Clinicians turn to negative pressure therapy when a wound is too deep, too wet or too large for ordinary dressings to manage well. A surgical incision that has come apart, a deep pressure injury, a foot wound after an operation or an injury with tissue loss can all produce more fluid than gauze or foam pads can hold, and the cavity left behind has a long way to fill in.
Suction under a sealed dressing removes that fluid continuously and encourages the healthy red tissue a wound needs before it can close. Sometimes the goal is full healing. Often it is narrower: get the wound clean, shallow and ready for stitches, a skin graft or a simpler dressing.
What the treating clinician looks at
The treating clinician looks past the wound to the person wearing the device. Is pain at dressing changes controlled well enough that changes happen on time? Can the person walk safely with the tubing, sleep, and keep the pump charged? Is a bed, chair or shoe pressing on the wound in a way suction cannot overcome? These answers count as much as the measurements.
The clinician also plans the exit early: what the wound should look like when the pump comes off, what dressing will replace it and whether a surgeon will close or graft the wound. Knowing the end point helps everyone judge whether each visit shows movement toward it.
Local context: Chesterfield and West County
In Chesterfield and West County, the surgeon or wound center that started the therapy may be a long drive away, and repeated round trips with a pump are tiring. Follow-up at home by a partner clinician can take the place of some of those trips, with notes sent back to the ordering surgeon. Many family caregivers here commute and are gone during the day. If that is your household, ask for dressing changes and clinician visits at times someone can be present, and keep a note by the pump listing what its alarms mean and whom to call.
Chesterfield and West County have a wide range of places to live as people age. Many residents stay in the two-story houses where they raised families. Others move to ranch villas, condominiums, independent living apartments or senior communities with assisted living, memory care and skilled nursing on one campus. Gateway arranges visits from partner clinicians across this range. When a resident moves from one level of care to another, we update the address, the facility contacts and the records so the treating clinician’s plan follows the person.
When care happens at home
At home, three parties usually share the work. A home health nurse changes the dressing on set days each week. A medical equipment supplier ships the pump, canisters and dressing kits. The treating clinician visits to examine the wound and update the orders.
Gateway schedules that clinician visit and, where possible, lines it up with a dressing change day so the wound is seen uncovered without an extra change. We also send the clinician’s notes and new orders to the home health agency, so the nurse who arrives next is working from the current plan.
In a facility
Rehabilitation adds movement to the picture. A resident on negative pressure therapy still goes to the therapy gym, transfers in and out of a wheelchair and practices stairs, all with a pump and tubing attached. The treating clinician and facility nurses work out where the tubing runs so it is not sat on or pulled, and therapists learn what an alarm means and whom to tell.
Discharge planning should start early in a rehabilitation stay. Before the resident leaves, the plan should settle which agency will change the dressing at home, whether the facility’s pump stays behind and a home unit must be ordered, and when the wound will next be seen.
Changes to report
Some problems belong to the device, and they still deserve a prompt call to the nurse or treating clinician, because a pump that is off has stopped helping:
- An alarm that keeps returning after the tubing and canister have been checked
- A dressing that is no longer firm and drawn down
- A hissing sound, or a film edge that will not stay stuck
- A pump that will not charge or turn on
- Fluid leaking from under the film
Bleeding is different. If bright red blood is filling the tubing or canister, call 911 and follow the emergency steps in the instructions that came with the pump.
How primary care fits in
A wound that drains into a canister is losing fluid and protein every day, and the body has to replace both while also building new tissue. That makes eating and drinking part of the wound plan. A primary care clinician can check weight trends, appetite and lab work, and can address nausea, swallowing trouble or a low mood that keeps someone from eating.
Gateway arranges primary care alongside wound care so these questions do not wait for a separate office trip. When the two clinicians share notes, a stalled wound prompts a look at nutrition, not only at the dressing.
Getting care arranged in Chesterfield and West County
Clinicians and facility staff referring a patient for wound VAC follow-up in Chesterfield and West County can call 314-325-0126 or fax 314-786-7966. Helpful to include: demographics and insurance, the working diagnosis, recent wound notes and measurements, current orders, the medication list and relevant test results. Please also tell us who should receive the treating clinician’s notes afterward. The online referral form takes contact details only, so clinical records should come by fax, not through the form. Gateway confirms that the referral arrived, checks availability for the patient’s address and lets your office know what has been scheduled.
When you call, it helps to know the subdivision or community name as well as the street address, since some neighborhoods are gated and many streets end in cul-de-sacs. Tell us about gate codes, long driveways and which entrance a facility prefers for visitors. Have the patient’s doctor and pharmacy names handy. Gateway also arranges care in Ballwin, Wildwood, Creve Coeur, Maryland Heights, Ellisville and Des Peres, and visits in Chesterfield and West County are planned with those neighboring areas in mind. Availability is confirmed by location and setting.
- County: St. Louis County, Missouri
- ZIP codes: 63017, 63005
- Nearby hospitals: St. Luke's Hospital in Chesterfield; Mercy Hospital St. Louis in Creve Coeur; Missouri Baptist Medical Center in Town and Country; Barnes-Jewish West County Hospital in Creve Coeur (not affiliated with Gateway)
- Nearby communities: Chesterfield, Ballwin, Wildwood, Ellisville, Des Peres, Creve Coeur
- Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation
Other conditions and nearby communities
Read the full guide to wound VAC therapy, or see everything Gateway arranges on the mobile wound care in Chesterfield and West County page.
- Diabetic foot ulcers
- Venous leg ulcers
- Pressure injuries and bed sores
- 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 and NPWT follow-up in Ballwin
- Wound VAC and NPWT follow-up in Wildwood
- Wound VAC and NPWT follow-up in Creve Coeur
Common questions
My parent is being discharged to Chesterfield and West County with a wound VAC. What should be in place first?
Ask the discharge planner four things: which home health agency will change the dressing and on what days, which supplier is sending the home pump and when it arrives, who will follow the wound after discharge, and whom to call after hours. Get the current orders and latest measurements in writing. Gateway can help arrange follow-up with a partner clinician and gather those records. Call 314-325-0126.
Can I sleep normally with a wound VAC?
Most people do, with a little setup. Put the pump on a stable surface where your instructions say it should sit, plug it in so it charges overnight, and route the tubing so you will not lie on it or catch it when you turn. If the wound is over the tailbone or hip, ask the clinician which positions to avoid. Tell the nurse if alarms keep waking you, since a recurring leak can often be fixed.
What happens after the wound VAC comes off?
The wound is usually not fully closed when therapy ends. The treating clinician switches to another dressing suited to a shallower wound, or a surgeon closes the wound or places a skin graft if that was the goal. Follow-up continues until the wound has healed, and the new dressing may need different supplies and a different change schedule. The pump goes back to the supplier.
Are homes in the western part of Chesterfield and West County, out along Wild Horse Creek Road, too far for visits?
They are within the area where Gateway arranges care. The western part of Chesterfield has longer drives between homes, so visits there may be grouped on particular days. Tell us the address and any details about gates or private roads. We confirm availability for the location and care setting, and we will tell you plainly if a visit cannot be arranged where you are.
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.