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

Part of building the plan is agreeing on the goal. For most people the goal is full closure, and the plan is aimed at removing whatever stands in the way. For some, especially people who are very frail or whose circulation cannot be improved, the treating clinician may talk with the patient and family about a different aim: keeping the wound stable, clean, comfortable and free of infection.

Either way, the clinician explains what they found, what they think is holding the wound back and what they recommend. You should come away knowing what the plan is, who does what, and how you will be able to tell whether it is working.

Arranging this care in Creve Coeur

Many households in Creve Coeur have been in the same home for decades, and the house has not changed as its owner has. A bedroom upstairs can mean sleeping in a recliner, which keeps the legs down all night and pressure on the tailbone. An old tub makes washing a leg wound awkward. The partner clinician sees these things on a home visit and can account for them in the plan. Gateway also asks about long-used favorites, such as a flattened seat cushion or tight house shoes, that may be working against the wound.

Creve Coeur sits where Olive Boulevard meets Interstate 270, a West County city that mixes medical offices and corporate campuses with established neighborhoods. Lindbergh Boulevard runs along its eastern side, and New Ballas Road runs north to south through the middle. Because two hospitals and many physician offices are inside the city limits, it is easy to assume care is always within reach. Yet a person with a slow-healing wound, a walker and no driver may find a one-mile trip as hard as a ten-mile one. Bringing care to the home or facility removes that trip.

When care happens at home

A home visit lets the treating clinician see things an exam room hides. The recliner where someone sleeps every night, the slippers worn all day, the step into the shower, the bandage supplies in a kitchen drawer: each can explain why a wound keeps stalling. The clinician assesses the wound at the bedside or in a favorite chair and writes orders based on what is realistic in that house.

Gateway schedules the visit, confirms who will be there and passes along records beforehand. Afterward we follow up on the orders so the plan does not sit on paper.

In a facility

For a resident in memory care, a wound that will not heal often has a behavioral side. The person may pull off dressings, scratch at the area, pace for hours on swollen legs, or be unable to say that something hurts. Staff who know the resident usually know these patterns well.

The treating clinician takes that knowledge into account when choosing dressings and how they are secured, and may suggest timing care for the calmest part of the resident’s day. A familiar staff member or relative at the visit helps. Gateway arranges those details ahead of time and updates the family or legal decision-maker afterward.

Signs to tell the clinician about

Because these wounds are judged by their trend, small shifts matter. Report any of the following between visits instead of waiting for the next one:

  • The wound looks wider or deeper, or a new opening appears nearby
  • Black, gray or yellow tissue that was not there before
  • Bone, tendon or surgical hardware visible in the base
  • Bleeding at a light touch
  • Fever, chills, nausea or unusual tiredness
  • A dressing that will not stay in place or cannot be done as ordered

Call 911 if a foot or leg suddenly becomes cold, pale or blue, or if the person is hard to wake, breathing fast or suddenly not making sense.

How primary care fits in

Some people with a long-standing wound have not seen a primary care clinician in a long while. Getting to an office may be the obstacle: stairs, a wheelchair, no ride, or a wound that leaks through its dressing on the way. Meanwhile blood pressure, weight, mood, sleep, tobacco use and mobility go unreviewed, and each has a hand in how skin repairs.

Gateway can arrange primary care in the same settings as wound care, including at home. One coordinated plan means fewer conflicting instructions and one place to call with questions. Each clinician still makes the decisions in their own area.

Primary care at home in Creve Coeur →

How to get started in Creve Coeur

Setting up non-healing wound care for someone in Creve Coeur usually goes in this order:

  1. You call 314-325-0126 or send the request care form, which asks only for a name and phone number.
  2. Gateway talks with you about the wound, the address and the insurance.
  3. We confirm availability for that location and gather records for the treating clinician.
  4. The clinician visits, assesses the wound and writes the orders.
  5. We follow up on supplies, the next visit and communication with your other clinicians.

You do not need a confirmed diagnosis to start.

Mercy Hospital St. Louis and Barnes-Jewish West County Hospital are both in Creve Coeur, and Missouri Baptist Medical Center in Town and Country is a short drive south. Gateway is not affiliated with these hospitals. A surgical or chronic wound often still needs attention after the patient goes home. Case managers can fax us a referral before discharge. Families can call with the hospital name and going-home date. Gateway requests the records, confirms the Creve Coeur address and setting, and arranges a follow-up visit with a treating clinician.

  • County: St. Louis County, Missouri
  • ZIP codes: 63141
  • Nearby hospitals: Mercy Hospital St. Louis in Creve Coeur; Barnes-Jewish West County Hospital in Creve Coeur; Missouri Baptist Medical Center in Town and Country (not affiliated with Gateway)
  • Nearby communities: Chesterfield, Maryland Heights, Chesterfield and West County, Ladue, Overland, Des Peres
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Related care in Creve Coeur

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

Common questions

How often will someone visit for a wound that is not healing in Creve Coeur?

The treating clinician sets the visit schedule based on the wound, the plan and who is changing dressings between visits. Chronic wounds are usually rechecked on a regular cycle so measurements can be compared, and the interval may change as the wound does. Gateway confirms what is available for your location and care setting and lets you know the schedule ahead of time.

Does insurance cover care for a non-healing wound?

You can ask us about Medicare, Medicare Advantage, Medicaid and commercial plans. Whether a visit, a dressing or a therapy is a covered benefit depends on your plan, the treating provider and the care that is needed, so we cannot answer in general terms. Gateway helps confirm these points before the visit where possible. Have your insurance card nearby when you call.

Who changes the dressing between visits?

It depends on the plan and the help available. Some people manage their own dressings, some rely on a spouse or adult child, and some have a home health nurse or facility nurse. The treating clinician writes the orders with that person in mind. If nobody is able to do the changes as ordered, say so, and the clinician can look at other options.

Creve Coeur has hospitals with outpatient services. Why would someone choose visits at home instead?

It depends on the person. Outpatient care suits people who can travel comfortably. Visits at home or in a facility suit people for whom the trip is painful, risky or dependent on someone else’s schedule. Some patients use both at different times. If you live in Creve Coeur and are unsure, call us and describe the situation. The treating clinician can advise on the right setting after an assessment.

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.