What to know about skin tears and traumatic wounds

Skin tears are seen most often in the oldest adults, but age is only part of the picture. The risk climbs for anyone who needs hands-on help to bathe, dress or move from bed to chair, because every assist puts force on the skin. It climbs again for people with memory loss, poor eyesight or unsteady balance, who bump into things and may not mention it. Swollen legs, a poor appetite and low fluid intake add to it, as do certain long-term medicines. One of the clearest warnings is a previous skin tear, since the conditions that caused the first are usually still there. Younger adults are not exempt. Serious illness and long hospital stays can leave skin just as fragile.

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.

Arranging this care in Lake St. Louis

Newer subdivisions and senior living communities are growing side by side in Lake St. Louis, and both produce skin injuries: a fall on a garage step, a shin against an open dishwasher door, a forearm caught during a transfer in a new assisted living apartment. What they share is distance from wound specialists. Gateway arranges follow-up where the person lives, in a house or facility, and coordinates with relatives who may only be reachable by phone during the workday. After each visit, the family contact can be updated on what the clinician found and what to watch for until the next one.

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.

When care happens at home

Most of a skin tear’s healing happens on the days nobody visits. Before leaving, the treating clinician explains who will change the dressing, when, and what to do if it slips, gets wet or soaks through. Many families are asked to do less than they expect: leave the dressing alone, keep the area protected, and watch. It helps to jot down dates and anything that looks different, to show at the next visit. If something worries you in between, call 314-325-0126. Gateway passes the message to the wound care team, and the clinician decides whether the plan or the visit schedule should change.

For residents of nursing and senior living communities

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.

What to report and when to call 911

Infection is the complication clinicians watch for most closely after a skin injury. Report these to the treating clinician or the facility nurse promptly:

  • Redness that is spreading outward from the wound
  • Skin around it that feels hot, hard or newly swollen
  • Thick, cloudy or foul-smelling drainage
  • Pain that is rising instead of easing
  • Fever, chills or feeling generally unwell

Call 911 if the person becomes confused, very drowsy, short of breath or faint, with or without a fever. Those can be signs that an infection is affecting the whole body and cannot wait for a scheduled visit.

How primary care fits in

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 Lake St. Louis →

Arranging skin tear and traumatic wound care in Lake St. Louis

People asking about skin tear and traumatic wound care in Lake St. Louis usually want to know what the first visit involves. Before it, Gateway collects the records the treating clinician asks for and confirms the time and place with you. During it, the clinician looks at the wound and the skin around it, measures it, asks about your health and medications and explains what they recommend. Afterward, the orders go to whoever does the daily care, supplies are requested and a follow-up is planned. Our guide to how mobile wound care visits work has more. To begin, call 314-325-0126. Whether a visit can be arranged is confirmed for your location.

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 skin tears and traumatic wounds, or see everything Gateway arranges on the mobile wound care in Lake St. Louis page.

Common questions

Will insurance pay for traumatic wound care at home in Lake St. Louis?

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.

Does Gateway arrange skin tear care in nursing homes and assisted living in Lake St. Louis?

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.

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.