About pressure injuries

A pressure injury is an area of damaged skin, and often damaged tissue underneath, that forms where the body rests against a surface for too long. Bed sore, pressure sore, pressure ulcer and decubitus ulcer all mean the same thing. These wounds nearly always sit over a bone that lies close to the skin, such as the tailbone, the hip, the heel, the ankle or the back of the head.

A pressure injury is not always an open sore. It can begin as a patch of unbroken skin that looks or feels different, and it can also be a deep crater. Clinicians describe that range with a staging system based on how many layers of tissue are involved. Staging gives everyone caring for the person a shared language for the wound.

How the care plan is built

After the assessment, the treating clinician writes orders and explains them to the people who will carry them out. A pressure injury plan usually has several parts:

  • Wound orders: how the wound is cleaned and covered, and how often the dressing is changed
  • Pressure relief: the mattress, cushion or heel protection to use
  • Positioning: which positions to use, which to avoid and how often to change
  • Skin care: keeping the area clean and dry after incontinence
  • Follow-up: when the wound will be checked again

Gateway follows up on the supply and equipment orders and shares the plan with the caregivers, home health nurses or facility staff involved.

Pressure injury and bed sore care in Madison County

Some people in Madison County have long crossed the river to St. Louis for specialty care. With a pressure injury, that trip means extended sitting in a car and then a clinic chair, which works against the wound. Gateway can check whether a partner clinician is available to visit the home or facility on the Illinois side instead. Coverage and the treating provider are confirmed before the visit, and records from hospitals in either state are gathered for the clinician.

Madison County reaches from the Mississippi River at Alton and Granite City, over the bluffs to Edwardsville, Glen Carbon, Maryville and Collinsville, and east through farmland to Troy and Highland. Godfrey, Wood River and Bethalto fill in the north. That is a lot of ground, and the distance to a wound clinic or a doctor’s office varies widely from one town to the next. People who cannot travel easily, whether they live in a river-town bungalow or on a rural road, gain the most when care is arranged where they live.

Care at home

A home visit shows the treating clinician things an office visit cannot: the mattress the person actually sleeps on, the chair they sit in most of the day, and how transfers happen in that room. For a pressure injury, those details are often the cause of the wound.

Gateway schedules the visit with a partner clinician once availability is confirmed for your address. Leave the bed and chair set up as they normally are. If the person uses a cushion, pillows or a lift, keep them in place. The clinician decides how often to return based on how the wound is doing.

In a facility

Pressure injuries in memory care come with particular challenges. A resident with advanced dementia may not be able to say that a spot hurts, may resist being turned, may sit in one favorite chair for hours, or may pull at a dressing. Staff who know the resident are usually the first to notice a change in mood, sleep or willingness to sit.

Partner clinicians see residents in the memory care setting, which spares the resident a trip to an unfamiliar clinic. The treating clinician takes behavior into account when writing orders, and Gateway shares the plan with nursing staff and the family member or representative who makes decisions.

Signs to tell the clinician about

Pressure damage can start before the skin opens. Check the tailbone, hips, heels and other bony areas when you help with bathing or dressing, and tell the treating clinician or nurse if you see:

  • A patch that stays red, purple, maroon or darker than nearby skin after the pressure is off
  • Skin that feels warmer, cooler, firmer or softer than the skin around it
  • A blister, a shiny area or a shallow break
  • A spot the person says is sore, burning or itchy

Call 911 if the person has trouble breathing, chest pain, or is suddenly very hard to wake.

Primary care and overall health

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.

Primary care at home in Madison County →

Arranging pressure injury care in Madison County

To arrange pressure injury care in Madison County, call Gateway at 314-325-0126. Patients, family members and caregivers can call directly, and a referral is not required. We will ask where the patient lives, what has been done for the wound so far and which clinicians are involved. Gateway then confirms whether a partner clinician is available for that address and care setting, requests the relevant records and schedules the visit. At that visit the treating clinician examines the wound and decides on the plan. Our job from then on is the coordination: orders, supplies, follow-up visits and keeping the care team informed.

A Madison County request goes more smoothly when the caller has the town and ZIP code, the type of residence, a phone number that will be answered, and the names of the doctors and any home health agency already involved. Gateway arranges care in Edwardsville, Glen Carbon, Collinsville, Granite City, Alton and Godfrey, among other communities. Because the county is large, availability differs between the river towns, the central communities and the eastern edge. We confirm it by address and care setting.

  • County: Madison County, Illinois
  • ZIP codes: 62025, 62034, 62234, 62040, 62002, 62035
  • Nearby hospitals: Anderson Hospital in Maryville; Alton Memorial Hospital; OSF Saint Anthony's Health Center in Alton; Gateway Regional Medical Center in Granite City; HSHS St. Joseph's Hospital in Highland (not affiliated with Gateway)
  • Nearby communities: Edwardsville, Glen Carbon, Collinsville, Granite City, Alton, Godfrey, Illinois
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Other conditions and nearby communities

Read the full guide to pressure injuries, or see everything Gateway arranges on the mobile wound care in Madison County page.

Common questions

Can a wound care clinician come to a home in Madison County to look at a bed sore?

Gateway arranges home visits by partner clinicians for people with pressure injuries, and availability is confirmed by location and care setting. When you call 314-325-0126, we ask for the address, whether the person is at home or in a facility, and who is already involved in their care. We then tell you what can be arranged for that address.

Does a bed sore mean someone was neglected?

Not necessarily. Many pressure injuries can be prevented with good positioning, skin care and equipment, and it is reasonable to ask how one developed. But they can also occur despite attentive care, especially in people who are very ill, very thin or near the end of life. The useful questions are what the plan is now and who is carrying out each part.

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.

How do Madison County facilities and discharge planners send a referral?

Referrals can be called in to 314-325-0126 or faxed to 314-786-7966. Include the patient’s name and contact details, where the patient is or will be, the reason for the referral, and recent notes, orders and a medication list if available. Gateway follows up with the referring office, checks availability for the location and keeps the referring team informed as the visit is arranged.

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.