About wound VAC therapy
People on a wound VAC have usually just been through something significant. Many are recovering from abdominal, orthopedic, vascular or foot surgery where the incision opened or was left open on purpose. Others have a deep pressure injury over the tailbone or hip, a diabetic foot wound that needed surgical cleaning, or a wound from an accident.
Because of that, the therapy often starts in a hospital and then follows the person to a rehabilitation center, a skilled nursing facility or home. The same person may be weak, eating poorly, or living with diabetes or poor circulation. Those facts shape how closely the wound and the device need to be watched after discharge.
What the treating clinician looks at
A follow-up visit works best when it lines up with a dressing change, because the treating clinician needs to see the wound uncovered. With the filler out, the clinician measures length, width and depth, checks for tunnels or undermined edges, and looks at the color and texture of the wound bed. Healthy tissue is red and slightly bumpy. Pale, dark or stringy tissue suggests the wound needs something more than suction.
The clinician compares those findings with earlier measurements and photographs, then confirms or changes the order: the pump setting, the type of filler, how often the dressing is changed and what the nurses should do if the seal is lost.
Arranging this care in Downtown St. Louis
Many people in Downtown St. Louis start negative pressure therapy at one of the large medical centers nearby and are discharged while the pump is still running. The surgeon’s clinic may be a short drive away, yet getting there with a pump, a fresh incision and a walk-up apartment is a real effort. Follow-up visits at home cut down on those trips, and the treating clinician’s notes can go to the surgical team between appointments. Older buildings raise small questions too: is there an outlet near the bed for overnight charging, and is the elevator working on dressing change days?
Homes in Downtown St. Louis are almost all multi-unit: converted lofts, high-rise apartment towers, senior apartment buildings and a smaller number of condominiums. Skilled nursing and rehabilitation centers lie a short distance away in neighboring parts of the city. Gateway arranges partner clinician visits to all of these settings. Before a downtown visit we confirm how to get past the front door, whether a building manager needs notice, and where the clinician can leave a car. We also ask where supply deliveries should go, since packages are handled differently in each building.
When care happens at home
Not every home starts with all the pieces in place. Some people are discharged with a pump before a home health agency has been confirmed, or the agency’s visit days do not match the ordered dressing schedule. When you call Gateway, we ask who ordered the therapy, who is changing the dressing now and when it was last changed, then work with the treating clinician and the agency to close the gaps.
Caregivers who work during the day can ask for a phone update after each clinician visit. When the clinician ends therapy, we help coordinate the return of the pump and the switch to new dressing supplies.
In a facility
Assisted living and memory care communities often do not have nurses who change negative pressure dressings, so a home health agency usually comes in for that, much as it would in a private home. Staff still need the basics: what the alarms mean, where the tubing should sit and who gets the call.
In memory care, a resident may tug at the tubing, peel the film or forget the pump when standing up. The treating clinician weighs that honestly and sometimes decides a different dressing is safer. Gateway keeps the community’s staff, the agency, the family and the clinician working from one current set of orders.
What to report and when to call 911
Smaller changes are worth reporting before they grow. Let the nurse or treating clinician know about:
- Blisters, a rash or raw skin under or beside the film
- New pain or a strong pulling feeling when the pump runs
- A sore spot where the tubing or its connector presses on the skin
- The pump being off, or the seal lost, for longer than your instructions allow
- Numbness, coldness or color change in the foot or hand beyond the dressing (call right away)
Do not wait on bleeding. Blood that is bright red, or a canister that fills with blood quickly, is an emergency. Call 911. Gateway is not an emergency service.
How primary care fits in
Medicines matter more than usual during negative pressure therapy. Blood thinners and some other drugs raise the chance of bleeding at the wound, so the wound clinician needs an accurate, current list. Never stop or change one on your own. Ask the prescriber.
Pain relief around dressing changes is another common question, and so are drugs that can slow healing, such as long-term steroids. A primary care clinician can review the whole list, including what was added in the hospital, and talk with the wound clinician about concerns. Gateway shares records between the two so neither is working from an old list.
Getting care arranged in Downtown St. Louis
People asking about wound VAC follow-up 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
Other conditions and nearby communities
Read the full guide to wound VAC therapy, or see everything Gateway arranges on the mobile wound care in Downtown St. Louis 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 the City of St. Louis
- Wound VAC and NPWT follow-up in the Central West End
- Wound VAC and NPWT follow-up in North St. Louis
- Wound VAC and NPWT follow-up in South St. Louis
Common questions
My parent is being discharged to Downtown St. Louis 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.
Does Gateway provide the wound VAC pump itself?
No. The pump, canisters and dressing kits come from a medical equipment supplier on a clinician’s order, or from the facility if you live in one. Gateway’s role is coordination: confirming what was ordered, following up with the supplier when something is late or the order changes, and sending records where they are needed. Questions about how the device works go to the support line listed on the pump.
Do wound VAC dressing changes hurt?
They can be uncomfortable, mostly when the film and filler come off. It varies with the wound and the person. Tell the nurse and the treating clinician if changes are painful, because there are options they can consider, such as the timing of pain medicine you are already prescribed or a different dressing material against the wound. Do not skip or put off a change because of pain without telling the clinician.
Can staff at a senior apartment building in Downtown St. Louis contact Gateway for a resident?
Yes, with the resident’s agreement. Service coordinators, building managers and social workers in Downtown St. Louis can call us to start a request or help a resident make the call. We need the resident’s name and phone number to begin. Medical details should be shared by phone, not through the web form. The resident chooses who Gateway may talk to about scheduling and care.
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.