What to know about non-healing wounds

Non-healing wound is a description, not a diagnosis. It means a break in the skin that is no longer moving toward closure with the care it has been getting. Clinicians also say chronic wound, stalled wound or hard-to-heal wound, and they mean roughly the same thing.

The label covers many kinds of wounds. A surgical incision that opened along part of its length, a shin scraped on a car door, a sore over the tailbone, an ulcer near the ankle or under the foot can all end up here. What they share is the pattern: nearly the same measurements visit after visit, or a wound that seals over and then breaks down again. Working out which kind of wound it really is comes first, because the right care depends on it.

What the treating clinician looks at

Part of building the plan is agreeing on the goal. For most people the goal is full closure, and the plan is aimed at removing whatever stands in the way. For some, especially people who are very frail or whose circulation cannot be improved, the treating clinician may talk with the patient and family about a different aim: keeping the wound stable, clean, comfortable and free of infection.

Either way, the clinician explains what they found, what they think is holding the wound back and what they recommend. You should come away knowing what the plan is, who does what, and how you will be able to tell whether it is working.

Non-healing wound care in Lake St. Louis

In many households in Lake St. Louis, the person helping with wound care leaves early for work and gets home late. A dressing plan that needs midday attention will not hold up. Tell us the real schedule, and the treating clinician can consider dressings with longer wear times, home health nursing or a different routine. We can set up visits so a family member joins by phone, and we send a plain summary afterward. Newer senior living communities in the area can be visited too, and we ask their staff what they are able to assist with.

Two lakes shape daily life in Lake St. Louis. The city was planned around them in western St. Charles County, in the stretch between Interstate 70 on the north and Interstate 64 on the south, with Wentzville to the west and O’Fallon to the east. It started as a lake community and still draws people who want to retire near the water. Many residents are older adults, and some live alone. Wound care and primary care that come to the home help them stay where they are.

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.

Care in skilled nursing and assisted living

People arrive at a rehabilitation center after surgery, a fracture or a long illness, and some bring a wound that was already slow before the hospital stay. Rehab adds its own pressures: therapy sessions, new braces or footwear, more hours sitting up, and a discharge date approaching.

A partner clinician can reassess the wound during the stay and coordinate with the therapy and nursing teams, for example on how a brace sits near the wound. Because the stay is short, Gateway also plans the handoff: where the patient is going next, who will change dressings there, and how follow-up visits will continue after discharge.

What to report and when to call 911

If you care for someone who cannot describe how they feel, you are the early warning. Let the treating clinician know about:

  • Guarding, flinching or crying out when the area is touched
  • Less interest in eating or drinking
  • New restlessness, sleepiness or confusion
  • A swollen limb, especially on one side only
  • Stains on bedding or clothing from drainage or blood

Write down the date you first noticed the change and mention it when you call. Do not wait on an emergency. Call 911 for bleeding you cannot control, fainting, a seizure, severe shortness of breath or sudden weakness on one side of the body.

Primary care and overall health

Two questions come up with nearly every stalled wound: what is this person eating, and what are they taking? Repair needs protein, calories, fluids and certain vitamins, and many older adults with wounds eat far less than they need. Some medicines, including steroids and drugs that act on the immune system, can slow repair as well.

Neither issue should be handled alone. Do not stop or change a medicine by yourself. A primary care clinician can review the full list with the wound in mind, check weight and labs, and weigh the tradeoffs. Arranging primary care alongside wound care makes that review far more likely to happen.

Primary care at home in Lake St. Louis →

How to get started in Lake St. Louis

Setting up non-healing wound care for someone in Lake St. Louis usually goes in this order:

  1. You call 314-325-0126 or send the request care form, which asks only for a name and phone number.
  2. Gateway talks with you about the wound, the address and the insurance.
  3. We confirm availability for that location and gather records for the treating clinician.
  4. The clinician visits, assesses the wound and writes the orders.
  5. We follow up on supplies, the next visit and communication with your other clinicians.

You do not need a confirmed diagnosis to start.

SSM Health St. Joseph Hospital in Lake Saint Louis is the closest hospital for most residents, and Progress West Hospital in O’Fallon is a short drive east. Neither is affiliated with Gateway. When a patient is being discharged with a surgical wound, a pressure injury or a leg ulcer, the family or the hospital case manager can contact us to ask about follow-up at the Lake St. Louis address. A fax to 314-786-7966 with the discharge summary and wound orders gives the treating clinician what is needed to plan a first visit.

  • County: St. Charles County, Missouri
  • ZIP codes: 63367
  • Nearby hospitals: SSM Health St. Joseph Hospital in Lake Saint Louis; Progress West Hospital in O'Fallon (not affiliated with Gateway)
  • Nearby communities: Wentzville, O'Fallon, Missouri, Dardenne Prairie, St. Charles County
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Other conditions and nearby communities

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

Common questions

How do I start non-healing wound care in Lake St. Louis 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.

Can a wound that has been open for years still heal?

Sometimes, and it is worth asking. The length of time alone does not rule out improvement. What matters is whether the things holding the wound back can be found and changed. Some long-standing wounds do close after the cause is addressed. Others cannot fully heal, and the aim becomes comfort and preventing infection. The treating clinician can give you an honest view after an assessment.

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.

Is Lake St. Louis within the area where Gateway arranges home visits?

Yes. Gateway arranges wound care and primary care in Lake St. Louis and across St. Charles County, including Wentzville, O’Fallon and Dardenne Prairie. Because the city is on the western side of the region, availability is confirmed for each address and care setting before anything is scheduled. Call 314-325-0126 with the address and we will tell you what can be arranged.

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.