About skin tears and traumatic wounds

A skin tear is an injury wound, not a disease. It forms when rubbing, a knock or a tug slides the outer layer of skin away from the layer beneath. Sometimes the top layer lifts as a flap that can be laid back down. Sometimes part or all of it is lost, leaving a raw, shallow, tender area that may bleed more than its size suggests. Traumatic wound is the larger family that skin tears belong to. It takes in lacerations (cuts), abrasions (scrapes), punctures, and hematomas, where blood collects under the skin after a blow. What these wounds share is a clear starting moment. What differs from person to person is how well the body underneath can repair them.

How the care plan is built

Much of the care plan for a skin tear comes down to what touches the wound and how it is held there. The treating clinician generally chooses a dressing with a gentle contact surface, one that can stay on for several days and release without lifting the flap or the skin around it. The clinician also decides how it is secured, often with a soft wrap or sleeve in place of tape, and who will change it. Past reactions to adhesives are worth mentioning at this point. Pain is part of the assessment too. A dressing change that hurts is looked into, because it can point to a dressing that sticks, to swelling or to infection.

Arranging this care in Ladue

Many houses in Ladue were built long before anyone planned for walkers. Narrow doorways, basement laundry stairs, high-sided tubs and sharp-cornered furniture that has stood in the same spot for decades account for many skin tears among people who have aged in place. A home visit lets the treating clinician see both the wound and the house that produced it. Small changes, such as cushioning a door frame or shifting a table, can matter as much as the dressing. Gateway arranges those visits and coordinates supplies so that care fits the home the person already knows.

Clayton Road and Ladue Road carry most of the traffic through Ladue, a residential city in Mid County just west of Clayton. Away from those two roads, the streets turn into quiet lanes with large wooded lots and houses set well back from the curb. Interstate 64 and Interstate 170 are both close. There is little commercial development inside the city limits, so most medical appointments mean a drive to a neighboring city. For someone with a wound or limited mobility, care arranged at home removes that trip.

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.

For residents of nursing and senior living communities

Assisted living raises a practical question that nursing facilities do not: who is allowed to change the dressing? Staffing and licensing differ from one community to the next, and many rely on a visiting nurse, a home health agency or the family for wound care tasks. Gateway sorts this out at the start. We ask the community what its staff can do, share the treating clinician’s orders with whoever will carry them out, and arrange for supplies to be on hand in the resident’s apartment. The wellness nurse or director receives an update after each visit, and the family is told about changes to the plan.

Changes to report

Not every warning sign is infection. With skin tears and bruising injuries, tell the treating clinician promptly if you notice:

  • A skin flap changing from pink to dusky, gray or black
  • A flap that has shifted, rolled up or come away with the dressing
  • A bruise that is getting bigger, tighter or shinier
  • Fresh bleeding that soaks through the dressing
  • Numbness, tingling or coolness below the injury

Call 911 for bleeding that keeps coming despite firm, steady pressure, or for a limb that suddenly turns pale, cold and very painful. Tell the dispatcher and the crew if the person takes a blood thinner.

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 Ladue →

How to get started in Ladue

You may already have a surgeon, a wound clinic or a home health nurse and still want help with skin tear and traumatic wound care closer to home in Ladue. 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.

After a hospital stay, people in Ladue most often come home from Missouri Baptist Medical Center in Town and Country, SSM Health St. Mary’s Hospital in Richmond Heights or Mercy Hospital St. Louis in Creve Coeur. All three are a short drive away, and none is affiliated with Gateway. Families can call us to ask about wound care or primary care follow-up once a discharge date is set. Hospital discharge planners can refer by phone or fax and include the discharge summary, wound orders and the name of the person who will be at the home.

  • County: St. Louis County, Missouri
  • ZIP codes: 63124
  • Nearby hospitals: Missouri Baptist Medical Center in Town and Country; SSM Health St. Mary's Hospital in Richmond Heights; Mercy Hospital St. Louis in Creve Coeur (not affiliated with Gateway)
  • Nearby communities: Clayton and Central County, Creve Coeur, Richmond Heights, Brentwood, University City
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Related care in Ladue

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

Common questions

Does Gateway arrange skin tear care in nursing homes and assisted living in Ladue?

Yes. Facility nurses, administrators and families can all make the request. We confirm that a partner clinician can visit that facility, then coordinate with the nursing staff on timing, records and orders. The treating clinician sees the resident on site. When a visit can be arranged, the resident does not have to be driven to an outside appointment for a wound check.

How is a skin tear different from an ordinary cut?

A cut is made by something sharp and usually has clean edges that go straight down. A skin tear is made by rubbing, bumping or pulling, and it peels the top layer of skin sideways, often leaving a thin flap. Skin tears tend to be shallow but wide, and they happen on skin too delicate for some of the closures used on cuts. That is why they are assessed and dressed differently.

Can a clinician come to a home in Ladue to check a skin tear?

In many cases, yes. Gateway arranges home visits from partner clinicians for skin tears, cuts, scrapes and bruising injuries that need follow-up. Availability depends on the address and the care setting, so we confirm it when you call 314-325-0126. You do not need a referral to ask. The clinician who visits assesses the wound and decides on the plan.

Can a private caregiver or household assistant call Gateway on behalf of someone in Ladue?

Yes. A caregiver, family member or assistant can make the first call for a patient in Ladue. We will ask for the patient’s name, address and phone number, and who should be the main contact for scheduling. If a home health agency or hired caregiver is already helping, tell us so the treating clinician knows who else is involved. The web form takes contact details only, so share medical information by phone.

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.