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
A pressure injury care plan depends on the whole person, so the treating clinician reviews more than the skin. Expect questions about how much the person can move without help, whether they can feel and report discomfort, how often skin is exposed to moisture, and how well they have been eating and drinking.
The clinician also asks what the person and family want from care. For one person the aim is to close the wound. For another, who is very frail, the aim may be to keep the wound stable, clean and comfortable. Being honest about what caregivers can manage each day helps the clinician write a plan that will be followed.
Pressure injury and bed sore care in Downtown St. Louis
In Downtown St. Louis, getting pressure-relief equipment into the home can be the hardest step. A hospital bed or specialty mattress may have to come up a narrow staircase or through a small elevator, and many families end up setting the bed in a first-floor living or dining room. Tell Gateway about stairs, entry codes and where a visiting clinician can park. We pass those details along when scheduling so the visit and any deliveries are planned around the building.
Downtown St. Louis is the central business district beside the riverfront, stretching west from the Gateway Arch through Downtown West. Many of its former warehouses and office buildings along Washington Avenue and the nearby streets are now lofts and apartments, and people of every age live among the stadiums, hotels and courthouses. Living downtown often means living without a car, in a building with elevators, secured doors and a front desk. For a resident with a wound or a chronic illness, care that comes up to the apartment is far simpler than arranging a ride out.
Care at home
Dressings are only part of what a pressure injury needs at home. The treating clinician may also order a pressure-redistributing mattress or overlay, a wheelchair cushion, heel protection or a hospital bed. Gateway follows up on those orders with suppliers and lets you know what to expect about delivery.
Dressings usually arrive in quantities meant to last until the next order. Check the box against what the clinician ordered, store it somewhere clean and dry, and tell us before the last few are used. Once equipment arrives, keep the instructions and the supplier’s phone number handy. Tell the clinician if a mattress feels flat, a cushion has shifted or the person will not tolerate it.
Care in skilled nursing and assisted living
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
Once a pressure injury is being cared for, the treating clinician needs to hear about changes in the wound between visits. Report any of these:
- The wound looks wider or deeper than it did at the last visit
- Black, brown, gray or thick yellow tissue appears
- Drainage increases, soaks through the dressing or changes color
- A new or stronger odor that remains after the wound is cleaned
- The edges lift or a pocket seems to open under the skin
Call 911 for bleeding from the wound that will not stop, or if the person collapses or cannot be roused.
How primary care fits in
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.
Arranging pressure injury care in Downtown St. Louis
People asking about pressure injury care in Downtown St. Louis usually want to know what the first visit involves. Before it, Gateway collects the records the treating clinician asks for and confirms the time and place with you. During it, the clinician looks at the wound and the skin around it, measures it, asks about your health and medications and explains what they recommend. Afterward, the orders go to whoever does the daily care, supplies are requested and a follow-up is planned. Our guide to how mobile wound care visits work has more. To begin, call 314-325-0126. Whether a visit can be arranged is confirmed for your location.
Three things make a request for care in Downtown St. Louis go smoothly. First, the full address with unit number and ZIP code, whether 63101, 63102 or 63103. Second, access details: call box name, door code, front desk hours, guest parking or the nearest garage. Third, a phone that will be answered when the clinician arrives. Ball games, concerts and street closures can affect timing, so we plan around them where we can. Gateway also arranges care in the Central West End, North St. Louis, South St. Louis and across St. Louis City.
- County: City of St. Louis, Missouri (an independent city)
- ZIP codes: 63101, 63102, 63103
- Nearby hospitals: SSM Health Saint Louis University Hospital; Barnes-Jewish Hospital (not affiliated with Gateway)
- Nearby communities: St. Louis City, Central West End, North St. Louis, South St. Louis
- Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation
Related care in Downtown St. Louis
Read the full guide to pressure injuries, or see everything Gateway arranges on the mobile wound care in Downtown St. Louis 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 the City of St. Louis
- Pressure injury and bed sore care in the Central West End
- Pressure injury and bed sore care in North St. Louis
- Pressure injury and bed sore care in South St. Louis
Common questions
How do we start pressure injury care for a family member in Downtown St. Louis?
Call Gateway or send the request form with a name and phone number only. You do not need a referral to call. On the phone we will ask where the person lives, how long the sore has been there, which hospital or doctor has seen it and what insurance they have. From there we gather records and work on scheduling with a partner clinician.
What is debridement, and will my family member need it?
Debridement means removing dead tissue from a wound so healthy tissue can grow and infection is less likely. There are several methods, some using dressings or ointments and some done by a clinician with instruments. Not every pressure injury needs it, and in some situations it is avoided. The treating clinician decides whether, when and how, and will explain the reasons.
What do the stages of a pressure injury mean?
Stages describe depth. Stage 1 is unbroken skin with a color change that does not fade. Stage 2 is a shallow open area or blister. Stage 3 extends into the fat layer under the skin. Stage 4 reaches muscle, tendon or bone. A wound is called unstageable when its base is hidden, and a deep tissue injury is a dark purple or maroon area where the damage lies below the surface.
Do ball games and street closures in Downtown St. Louis affect home visits?
They can affect timing, and visits can be planned around them. Event days bring traffic, closed blocks and full garages near the stadiums and the convention center. If you know a big event falls on your visit day, mention it. We may suggest a different time of day, and the clinician may call when they are close. Tell us which entrance is easiest to reach during closures.
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.