What to know about non-healing wounds

A stalled wound rarely stays exactly the same. Over weeks and months it tends to drift. It may look a little better for a stretch, then worse after a swollen week, a fall or a few missed dressing changes. Drainage rises and falls. The skin around it may turn soggy and pale from moisture, or dry, hard and callused at the rim.

The longer a wound stays open, the more its edges and base can change in ways that make closing harder, and the more opportunity bacteria have to settle in. That is why clinicians record size, depth and tissue appearance at each visit and compare them over time. A single snapshot says little. A month of measurements shows whether the plan is working or needs to change.

What an assessment covers

A care plan for a stalled wound usually has several parts working together, because one change alone is seldom enough. The treating clinician may decide on some combination of:

  • Clearing unhealthy tissue so the wound bed can rebuild
  • A dressing matched to how much the wound drains
  • Taking weight or friction off the area
  • Controlling swelling in the limb
  • Referral to a vascular, surgical, dermatology or infectious disease specialist

Each part is assigned to someone: the clinician, a nurse, a caregiver or the patient. The plan also sets a point at which progress will be judged and the approach reconsidered if the wound has not responded.

Local context: Hazelwood

People in Hazelwood often move between home, a nearby rehabilitation unit and a senior living community as their health changes, and a chronic wound travels with them. Each move risks a different dressing, a lost measurement history and a new set of nurses starting from zero. Gateway keeps the wound’s history together across those settings and arranges for a treating clinician to follow it where the person is staying, when availability allows. If an adult child nearby helps with dressings, we include them in scheduling and updates when the patient agrees.

Hazelwood stretches along Interstate 270 in North County, an irregularly shaped city bordered by Florissant, Bridgeton and the land around Lambert airport. Warehouses and business parks share the map with residential streets, and Lindbergh Boulevard ties the two together. People here are used to getting on the highway for almost everything. That works until a health problem makes travel difficult. Wound care and primary care brought to a Hazelwood home or care facility let treatment go on without a highway trip each time, which matters most for patients who depend on someone else to drive.

At home between visits

A home visit lets the treating clinician see things an exam room hides. The recliner where someone sleeps every night, the slippers worn all day, the step into the shower, the bandage supplies in a kitchen drawer: each can explain why a wound keeps stalling. The clinician assesses the wound at the bedside or in a favorite chair and writes orders based on what is realistic in that house.

Gateway schedules the visit, confirms who will be there and passes along records beforehand. Afterward we follow up on the orders so the plan does not sit on paper.

For residents of nursing and senior living communities

For a resident in memory care, a wound that will not heal often has a behavioral side. The person may pull off dressings, scratch at the area, pace for hours on swollen legs, or be unable to say that something hurts. Staff who know the resident usually know these patterns well.

The treating clinician takes that knowledge into account when choosing dressings and how they are secured, and may suggest timing care for the calmest part of the resident’s day. A familiar staff member or relative at the visit helps. Gateway arranges those details ahead of time and updates the family or legal decision-maker afterward.

Signs to tell the clinician about

Not every change is an emergency, but these deserve a prompt call to the treating clinician’s office:

  • Red streaks running up the arm or leg from the wound
  • Pus, or drainage that turns green, tan or cloudy
  • Home blood sugar readings well above your usual range
  • Numbness, tingling or new swelling below the wound
  • A wound that had closed and has opened again

If you cannot reach the office and you are worried, go to urgent care or an emergency department. Call 911 right away for spurting or uncontrolled bleeding, chest pain or pressure, difficulty breathing, or a limb that suddenly turns cold and discolored.

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 Hazelwood →

Arranging non-healing wound care in Hazelwood

You may already have a surgeon, a wound clinic or a home health nurse and still want help with non-healing wound care closer to home in Hazelwood. That is a fine reason to call 314-325-0126. Tell us who is treating the wound now and what is not working, whether that is the travel, the gaps between appointments or unclear instructions. Gateway does not replace your current clinicians. We can arrange for a partner clinician to see the wound where you live and, with your permission, share notes with the offices already involved so the plans agree.

SSM Health DePaul Hospital in Bridgeton is the closest hospital for most of Hazelwood, and Christian Hospital in North County is a short drive east on Interstate 270. Gateway is not affiliated with either one. Patients sent home with a surgical wound, a pressure injury or a leg ulcer need someone to follow it. Discharge planners can fax a referral with orders and demographics. Family members can call with the hospital name and discharge date. Gateway requests the records, confirms the Hazelwood address, and arranges the follow-up visit with a treating clinician.

  • County: St. Louis County, Missouri
  • ZIP codes: 63042
  • Nearby hospitals: SSM Health DePaul Hospital in Bridgeton; Christian Hospital in North County (not affiliated with Gateway)
  • Nearby communities: Florissant, Bridgeton, Ferguson, Maryland Heights, North County
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Related care in Hazelwood

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

Common questions

How do I start non-healing wound care in Hazelwood 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.

How often will someone visit for a wound that is not healing in Hazelwood?

The treating clinician sets the visit schedule based on the wound, the plan and who is changing dressings between visits. Chronic wounds are usually rechecked on a regular cycle so measurements can be compared, and the interval may change as the wound does. Gateway confirms what is available for your location and care setting and lets you know the schedule ahead of time.

Hazelwood is spread out along Interstate 270. Is every part of the city included?

You can request care from any part of Hazelwood, whether you live near Lindbergh Boulevard, close to the airport or toward the Florissant line. Because the city is so spread out, the partner clinicians available may differ from one end to the other. Give us the street address and we will confirm availability for that location and care setting.

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.