About 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

For any injury below the knee, the treating clinician examines the leg, not only the wound. Pulses at the foot and ankle, skin temperature and color, and hair and nail growth give clues about blood flowing in. Swelling, brownish staining around the ankle and bulging veins give clues about blood flowing back out. Both matter, because a shin wound on a swollen or poorly supplied leg behaves like a leg ulcer in the making. If the findings raise questions, the clinician may order circulation testing before deciding how swelling should be managed. The care plan then covers the leg as a whole: protecting the wound, controlling fluid, and guarding the shin against the next knock.

Skin tear and traumatic wound care in Hazelwood

People in Hazelwood often move between settings without leaving the area: home, a hospital stay after a fall, a spell of rehabilitation, then home again or into assisted living down the road. An injury wound travels with them, and dressing plans tend to get lost at each handoff. Because Gateway arranges care in private homes and in the senior living communities and skilled nursing facilities close by, the same wound orders, records and supply list can follow the person. The treating clinician picks up from the last note instead of starting over.

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

Some people with a traumatic wound already have a home health agency coming in, or qualify for one after a hospital stay. In that case the treating clinician’s orders go to the agency nurses who do the dressing changes, and Gateway keeps the two sides in step: shared notes, updated orders, and one plan instead of two. Supplies are handled the same way. The clinician orders the dressings and wraps the wound needs, and we coordinate getting them to the house so nobody is improvising from the medicine cabinet. Whether home health or particular supplies are covered depends on the plan and the provider.

Care in skilled nursing and assisted living

Rehabilitation centers move fragile people on purpose. Therapy means transfers, gait belts, braces, parallel bars and wheelchair leg rests, and each one can catch a shin or a forearm. Many patients also arrive with wounds from the fall or accident that led to the admission. The treating clinician coordinates with nursing and the therapy team so that dressing changes fit around sessions and protective padding does not get in the way of exercise. Stays are short, so the discharge plan matters. Gateway can help carry the wound orders, supply needs and follow-up visits to the next setting, whether that is home or long-term care.

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.

How primary care fits in

Several common medicines change how skin injures and heals. Blood thinners make bleeding and bruising heavier. Long-term steroid medicines can thin the skin. Medicines that cause drowsiness or lower blood pressure make a fall more likely. None of this means a medicine should be stopped. These drugs are prescribed for serious reasons, and only the prescriber should adjust them. What primary care can offer is a full medication review with the wound in mind, along with a check of vaccination records. Gateway shares the wound clinician’s notes with the primary care clinician, so that review starts from what was seen at the bedside.

Primary care at home in Hazelwood →

Getting care arranged in Hazelwood

For a resident of a nursing home, assisted living or memory care community in Hazelwood, a request for skin tear and traumatic 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.

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

Other conditions and nearby communities

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

Common questions

Is Gateway the right call for a fresh injury in Hazelwood, or should we go to the emergency room?

Gateway is not an emergency service. A wound that is deep, gaping, bleeding heavily, caused by a bite or holding a foreign object needs urgent or emergency care first, and 911 if the situation is serious. We arrange what comes after: follow-up visits for a wound that has already been seen, or assessment of a skin tear or scrape that is not an emergency but is not healing well.

Can the person shower with a skin tear dressing on?

Ask the treating clinician, because the answer depends on the dressing and where the wound is. Some dressings tolerate a brief shower and others must stay dry. In general, avoid soaking the area in a bath and pat the surrounding skin dry instead of rubbing. If the dressing loosens or water gets under it, follow the instructions you were given or call.

Do skin tears need stitches?

Often not. Very thin skin may not hold stitches well, so clinicians frequently rely on other ways to settle a flap back in place and protect it while it heals. The choice belongs to the clinician who examines the wound. A deep or gaping injury is a different matter and should be seen urgently, because it may need to be closed soon after it happens.

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.