What to know about non-healing wounds

Several common beliefs about slow wounds do not hold up. One is that a wound should be left open to the air to dry out and scab. For most chronic wounds clinicians aim for a moist, protected surface instead, though the choice of dressing is theirs to make. Another is that no pain means no problem. People with nerve damage can have a serious wound and feel almost nothing.

A third mistake is treating a wound that will not heal as a normal part of getting older. Age slows repair, but age alone does not keep a wound open. And many families assume a stronger cream is the missing piece, when the real barrier is pressure, swelling or blood flow that no ointment can correct.

What the treating clinician looks at

When a wound has not responded to reasonable care, the treating clinician may want more information than an exam can give. Depending on the findings, that can mean a check of blood flow to the leg, blood work, a culture, imaging of the bone beneath the wound, or a small tissue sample to rule out an unusual cause.

Not every wound needs every test. The clinician chooses based on where the wound is, how it looks and how it has behaved. Gateway’s part is practical: we help get the orders to the right lab or imaging service, track the results and see that they reach the clinician before the next decision is made.

Local context: Edwardsville

Many people in Edwardsville have crossed the river for years to see a vascular surgeon, podiatrist or wound clinic in St. Louis, while their primary care, pharmacy and home health agency are in Illinois. With a stalled wound, that split can leave no one holding the full picture. Gateway collects notes from both states and gets them to the treating clinician. If a test or specialty visit is ordered, we ask whether your plan requires an Illinois location or a referral before anything is booked. Coverage depends on your plan and the treating provider.

Edwardsville is the Madison County seat and the home of Southern Illinois University Edwardsville. The courthouse anchors a busy Main Street, the campus fills the west side of town, and the neighborhoods run from the historic Leclaire district to newer subdivisions out toward Interstate 55. Some older residents have lived in the same house for decades, and others have moved here to be near family. For a person whose wound needs regular attention, or who has trouble getting around, even a short drive takes planning. Care arranged at home or in a facility avoids it.

At home between visits

Family caregivers often carry a non-healing wound for months: changing dressings before work, washing linens, worrying about every new stain on the bandage. If that is you, plan to be present for the visit, in person or by phone. The treating clinician can show you what they are seeing and explain the dressing routine in plain terms.

Say honestly what you can and cannot do. A plan that calls for daily changes will fail if nobody is home during the day. The clinician can often choose an approach that fits the help available, or consider whether home health nursing is appropriate.

Care in skilled nursing and assisted living

Assisted living communities are not set up like nursing homes. Staff may help with medications and bathing but are often limited in the wound care they can provide, so a resident with a stalled wound can fall between services. Dressing changes may depend on a visiting home health nurse, a family member or the resident.

Gateway helps sort out who is doing what. We arrange the partner clinician’s visit to the resident’s apartment, find out what the community’s staff can assist with, and coordinate with any home health agency involved. The resulting plan is written for the help that is really available.

What to report and when to call 911

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.

Why primary care matters here

Blood sugar is one of the strongest links between general health and a wound that will not close. When sugar runs high, the cells that fight infection and build new tissue work poorly, and small blood vessels deliver less. A wound clinician can choose the right dressing at every visit and still see little progress if diabetes control has slipped.

That is primary care territory: reviewing readings, lab results and the overall diabetes plan. When Gateway arranges both kinds of care, the wound findings reach the clinician managing the diabetes, and changes on that side are known to the wound care team.

Primary care at home in Edwardsville →

Getting care arranged in Edwardsville

For a resident of a nursing home, assisted living or memory care community in Edwardsville, a request for non-healing wound care can come from the family, the resident or the facility’s nurses. Call 314-325-0126 and give us the facility name, the unit or room and the best nurse contact. Gateway speaks with the facility about its process for outside clinicians, confirms availability and coordinates a visit time that fits the resident’s day. After the visit, the treating clinician’s orders are given to facility nursing, and the family contact on file gets an update if the resident has agreed to that.

Anderson Hospital in Maryville, a few miles south on Route 159, is the closest hospital to Edwardsville, and some residents are treated at hospitals in St. Louis as well. Gateway is not affiliated with Anderson Hospital. Families can call us before or after a discharge to ask about follow-up at home. Discharge planners and case managers can refer by phone or by fax at 314-786-7966. Either way, we collect the discharge summary and orders, confirm the address or facility the patient is returning to, and arrange the visit with a partner clinician.

Other conditions and nearby communities

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

Common questions

How do I start non-healing wound care in Edwardsville if I do not have a referral?

Call 314-325-0126 or use the request form, which asks only for a name and phone number. Please leave medical details out of the form. We call back, ask about the wound, your location and the care setting, and confirm whether a partner clinician is available. With your permission we then request earlier records so the first visit is well informed.

My wound has been treated for months. What would a new clinician do differently?

A reassessment goes back to the cause instead of continuing the same routine. The treating clinician reviews the history, remeasures the wound and looks for barriers that may have been missed, such as pressure, swelling, poor blood flow or a hidden infection. They may order tests or suggest a specialist. Sometimes the plan changes a great deal, and sometimes only one piece does.

Can a wound that has been open for years still heal?

Sometimes, and it is worth asking. The length of time alone does not rule out improvement. What matters is whether the things holding the wound back can be found and changed. Some long-standing wounds do close after the cause is addressed. Others cannot fully heal, and the aim becomes comfort and preventing infection. The treating clinician can give you an honest view after an assessment.

Is there a Gateway clinic in Edwardsville where I can be seen?

No. Gateway does not have a walk-in clinic in Edwardsville. Its administrative office is in Chesterfield, Missouri, and patients are not seen there. Visits are arranged with partner clinicians where the patient lives or is staying, such as a home, an assisted living apartment or a skilled nursing facility. If the treating clinician recommends an outpatient or office setting, we help coordinate that as well.

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.