Understanding skin tears and traumatic wounds

The most common mistake is the name people give it: just a scratch. On fragile skin, a scratch on the shin can become a long, stubborn problem, and waiting to see is how many of them begin. The second is the old advice to let a wound dry out in the open air. Clinicians today generally prefer a wound kept covered and protected, and the treating clinician will say what suits this one. The third is trusting whatever bandage is in the cabinet. A strong adhesive can strip skin when it comes off and leave a second wound beside the first. Finally, families sometimes read a skin tear as proof of rough handling. It can happen during careful, gentle care, though repeated tears deserve a closer look at how and when they occur.

How the care plan is built

A care plan for a traumatic wound answers more than what goes on it. The treating clinician sets out:

  • The goal for this wound and what progress should look like by the next visit
  • The dressing orders and who carries them out
  • What caused the injury and what will change so it does not repeat
  • Which findings would prompt a referral, such as a deeper wound than expected or tissue that has died

The plan is written down and shared with the people doing the daily care. At each visit the clinician checks the wound against the last measurement and adjusts the orders. Gateway keeps those orders, supplies and updates moving between visits.

Skin tear and traumatic wound care in Granite City

On the Illinois side of the river, an injury is usually first treated at an Illinois hospital or urgent care, and the insurance behind it may be an Illinois Medicaid plan or a Medicare Advantage plan with its own provider list. Before a wound visit is scheduled in Granite City, Gateway confirms which partner clinician can see the person in Illinois and helps the family raise the right questions with the plan. A fresh skin tear should not be left waiting on paperwork, so call once the injury has been seen. We request the hospital records in the meantime.

Directly across the Mississippi from north St. Louis, Granite City spreads over the flat river bottom of Madison County. It grew up around steelmaking, and its neighborhoods show it: close-set houses on a street grid and families who have been here for generations. Illinois Route 3 runs through town, Interstate 270 passes to the north and the McKinley Bridge is a short drive south. For residents who are older, live alone or no longer drive, getting to a clinic on either side of the river is difficult. Care arranged at home or in a facility comes to them instead.

At home between visits

Home visits suit this kind of wound for a simple reason: the person who has just fallen or torn their skin is often the person least able to travel. After you contact Gateway, we learn where the person lives and what happened, gather any urgent care or emergency room paperwork, confirm that a partner clinician is available for that address, and schedule the visit. The clinician assesses the wound at home, with the chair, the bed and the bathroom that may have played a part in plain view. Orders and supplies are coordinated from there, and we stay in touch with the family about what comes next.

In a facility

In a skilled nursing facility, a skin tear is usually found by an aide or nurse during morning care or after a transfer. The facility documents it, notifies the attending physician and the family, and can refer to Gateway for a wound care visit. The treating clinician assesses the resident at the bedside and writes orders that facility nurses carry out between visits. Findings go back to the attending physician, the director of nursing and the wound nurse, so the chart tells one consistent story. Because many tears happen during bathing, dressing and repositioning, the clinician can also advise on handling and protective measures for that resident.

Changes to report

When the wound came from a fall, the skin may not be the most serious injury, and some problems show up hours or days later. Let the treating clinician know about:

  • New pain in a hip, wrist, shoulder, ribs or back
  • Limping, or reluctance to stand or use an arm
  • Dizziness on standing, more unsteadiness or another fall
  • A wound that looks no better from one week to the next

Call 911 if the person hit their head and then develops a severe headache, vomiting, confusion, unusual sleepiness or trouble speaking, or if an arm or leg looks misshapen or cannot bear weight.

Primary care and overall health

A skin tear is often the visible part of a fall, and a fall usually has causes that can be found. A primary care clinician can check blood pressure lying and standing, review vision and hearing, look at feet and footwear, test strength and balance, and ask about dizziness and nighttime trips to the bathroom. Small findings add up. When Gateway arranges wound care and primary care together, the wound clinician’s account of how the injury happened reaches the clinician who can look into why. Any next steps, such as therapy or equipment, are coordinated alongside the wound visits instead of as a separate errand.

Primary care at home in Granite City →

Getting care arranged in Granite City

To arrange skin tear and traumatic wound care in Granite City, 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.

Gateway Regional Medical Center in Granite City is the local hospital, and Anderson Hospital in Maryville is a drive to the east. Despite the similar name, Gateway Wound Care is a separate company and is not affiliated with either hospital. After a stay at one of them, or at a hospital in St. Louis, a relative or a discharge planner can ask us to arrange follow-up. We request the discharge orders, find out whether the patient is going home or to a facility, and set up a visit with a partner clinician once availability for that location is confirmed.

Related care in Granite City

Read the full guide to skin tears and traumatic wounds, or see everything Gateway arranges on the mobile wound care in Granite City page.

Common questions

Will insurance pay for traumatic wound care at home in Granite City?

It depends on the plan, the treating provider and the care that is needed, so we cannot tell you in advance that a service is a covered benefit. You can ask us about Medicare, Medicare Advantage, Medicaid and commercial plans. Keep the insurance card handy when we talk, and we will help you work out which questions to put to the plan and the provider before care begins.

How often will the wound be looked at?

The treating clinician sets the schedule after the first assessment. It depends on the wound’s size and location, how much it drains, the dressing chosen and who is available to help between visits. Skin tears generally do better when they are not uncovered more than necessary, so fewer checks is not a sign of less care. If the wound changes, the schedule can change too.

What should I have ready when I call about an injury wound?

A name and phone number are enough to start, and the web form asks for nothing more. For the conversation that follows, it helps to know when and how the injury happened, where on the body it is, what care it has had so far and where the person lives. A medication list, insurance card and any discharge papers from urgent care or the hospital are useful too.

Is Gateway Wound Care part of Gateway Regional Medical Center in Granite City?

No. The names are similar, but Gateway Wound Care is a separate company and is not affiliated with Gateway Regional Medical Center. Gateway Wound Care arranges wound care and primary care with partner clinicians in homes and facilities, and it is not a hospital. If you are trying to reach the hospital, use the hospital’s own phone number. To ask about wound care or primary care visits, call Gateway Wound Care at 314-325-0126.

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.