About pressure injuries

Anyone who cannot easily change position is at risk, at any age. That includes people recovering from a hip fracture or major surgery, people with a spinal cord injury or advanced multiple sclerosis who use a wheelchair full time, people weakened by a stroke, and people in the later stages of dementia or another serious illness.

Loss of feeling matters as much as loss of movement. Someone with nerve damage may not notice the ache that tells the rest of us to shift. Very thin people have less padding over bone. People who wear oxygen tubing, splints, braces or casts can develop the same kind of injury wherever a device presses on skin. Several of these risks often appear together in one person.

What an assessment covers

The first visit starts with a close look at the wound itself. The treating clinician notes exactly where it is, measures its length, width and depth, and checks whether it extends under the skin edges. The type of tissue in the wound bed matters, as does the amount and color of drainage and the condition of the skin around it.

From these findings the clinician assigns a stage, or records that the wound cannot be staged yet because its base is hidden. The same measurements are repeated at later visits. Comparing them over time is how the clinician judges whether the current orders are working or need to change.

Arranging this care in Edwardsville

Some people in Edwardsville 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.

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

Most pressure injury care happens in the hours between visits. Someone has to change the dressing as ordered, help the person turn, keep skin clean after incontinence and look over the bony areas for new color changes. Before the clinician leaves, ask who is expected to do each task and what to do if a dressing comes loose early.

A simple written log helps. Note position changes, dressing changes and anything that looks different, and show it at the next visit so the clinician can see what the days are really like. Call Gateway at 314-325-0126 if supplies are running short or a visit needs to be moved.

For residents of nursing and senior living communities

Assisted living communities are not staffed like nursing homes, and that shapes pressure injury care. Aides may help with bathing and transfers, but skilled dressing changes are often done by a visiting home health nurse or, where the community’s license allows, by its own nurse.

When Gateway arranges a wound visit in assisted living, we ask early who handles each part: dressing changes, repositioning, incontinence care and equipment. The treating clinician’s orders are shared with the community’s nurse or director, the home health agency if one is involved, and the family. A resident who now needs far more hands-on help may prompt a wider talk about the level of care.

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.

Primary care and overall health

The body builds new tissue from what a person eats and drinks, and a pressure injury raises the demand. Someone who has lost weight, eats only a few bites at meals, has trouble swallowing or has poorly fitting dentures may not be taking in enough protein, calories or fluid to keep up.

A primary care clinician can look for the reason appetite has fallen, review weight over time and decide whether a dietitian or a swallowing evaluation would help. Gateway can arrange primary care in the same home or facility where wound visits take place, so the clinician who orders the dressing and the clinician who looks at nutrition are working from the same information.

Primary care at home in Edwardsville →

Getting care arranged in Edwardsville

Clinicians and facility staff referring a patient for pressure injury care in Edwardsville can call 314-325-0126 or fax 314-786-7966. Helpful to include: demographics and insurance, the working diagnosis, recent wound notes and measurements, current orders, the medication list and relevant test results. Please also tell us who should receive the treating clinician’s notes afterward. The online referral form takes contact details only, so clinical records should come by fax, not through the form. Gateway confirms that the referral arrived, checks availability for the patient’s address and lets your office know what has been scheduled.

Before you call, write down the patient’s address in Edwardsville (ZIP code 62025), a callback number, the date of any recent hospital stay and the name of the doctor the patient sees most often. If you live out of town, tell us who can answer the door on the day of a visit. Gateway also arranges care in Glen Carbon, Collinsville, Granite City, Alton and elsewhere in Madison County. Availability is checked for each address and care setting before we offer a time.

More wound care in Edwardsville

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

Common questions

Does Gateway work with nursing homes and assisted living communities in Edwardsville?

Yes. Gateway arranges for partner clinicians to see residents with pressure injuries in skilled nursing, assisted living, memory care and rehabilitation settings, either one resident at a time or through regular wound rounds. Facility staff can refer a resident, and families can ask the facility to contact us. Availability for a specific building is confirmed when the request comes in.

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.

What should we have ready before the first wound care visit?

Have a current medication list, any hospital or rehab discharge papers, the insurance cards and the dressings you are using now. Write down when the sore was first noticed and how it has changed. Jot down your questions too, including who to call between visits. If several people share caregiving, try to have the main helper present to hear the plan.

I have trouble with the front steps of my older house in Edwardsville. Can a visit still happen at home?

Yes. Difficulty leaving the house is a common reason people ask for care at home. When you call, describe the entrance and where in the house you spend most of the day, so the visiting clinician knows what to expect. A chair with good light and a clear path to it are usually enough. Availability is confirmed for your address before a visit is set.

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.