What to know about pressure injuries
Pressure injuries change slowly, and the early changes can be confusing. Damage that started deep may take days to show on the surface, so a wound can look worse at first even while care is going well. Dead tissue has to clear before new tissue can grow.
Healing happens from the base upward as the wound fills in and the edges draw together. The treating clinician tracks this with measurements at each visit, because week-to-week change is hard to judge by eye. Once closed, scar tissue forms over the area, and it is weaker than the original skin, so the same spot can break down again. Protecting that area continues long after the wound has closed.
What the treating clinician looks at
Part of every assessment is deciding whether the wound needs more than dressings and pressure relief. The treating clinician checks for signs of infection in the wound and the tissue around it, and looks for dead tissue that may be slowing progress. In a deep wound, the clinician considers whether bone could be involved.
Depending on what is found, the clinician may order lab work or imaging, or refer the person to a surgeon or another specialist. None of this is automatic. Each step is the clinician’s decision, based on the wound, the person’s health and the goals of care. Gateway helps arrange any orders or referrals that follow.
Arranging this care in Maryland Heights
In the older single-family homes common across Maryland Heights, the bedrooms are often upstairs, and a person with a pressure injury may have started sleeping in a living room recliner. Recliners put steady weight on the tailbone and heels, and a spouse of the same age may not be able to help with turning. A home visit lets the treating clinician see that setup directly and write orders that fit it, including whether a different sleeping surface should be considered.
Interstate 270 and Page Avenue cross in Maryland Heights, which puts this St. Louis County city within reach of most of the region. It runs from residential streets along Dorsett Road west to Creve Coeur Lake and the Missouri River bottoms. The city mixes subdivisions with office parks and a large number of apartment communities, so neighbors range from retirees in longtime family homes to renters who arrived recently. Both groups include people who cannot easily get to a clinic, and care arranged at home or in a facility fills that gap.
When care happens at home
A home visit shows the treating clinician things an office visit cannot: the mattress the person actually sleeps on, the chair they sit in most of the day, and how transfers happen in that room. For a pressure injury, those details are often the cause of the wound.
Gateway schedules the visit with a partner clinician once availability is confirmed for your address. Leave the bed and chair set up as they normally are. If the person uses a cushion, pillows or a lift, keep them in place. The clinician decides how often to return based on how the wound is doing.
For residents of nursing and senior living communities
Pressure injuries in memory care come with particular challenges. A resident with advanced dementia may not be able to say that a spot hurts, may resist being turned, may sit in one favorite chair for hours, or may pull at a dressing. Staff who know the resident are usually the first to notice a change in mood, sleep or willingness to sit.
Partner clinicians see residents in the memory care setting, which spares the resident a trip to an unfamiliar clinic. The treating clinician takes behavior into account when writing orders, and Gateway shares the plan with nursing staff and the family member or representative who makes decisions.
What to report and when to call 911
Pressure damage can start before the skin opens. Check the tailbone, hips, heels and other bony areas when you help with bathing or dressing, and tell the treating clinician or nurse if you see:
- A patch that stays red, purple, maroon or darker than nearby skin after the pressure is off
- Skin that feels warmer, cooler, firmer or softer than the skin around it
- A blister, a shiny area or a shallow break
- A spot the person says is sore, burning or itchy
Call 911 if the person has trouble breathing, chest pain, or is suddenly very hard to wake.
Primary care and overall health
The body builds new tissue from what a person eats and drinks, and a pressure injury raises the demand. Someone who has lost weight, eats only a few bites at meals, has trouble swallowing or has poorly fitting dentures may not be taking in enough protein, calories or fluid to keep up.
A primary care clinician can look for the reason appetite has fallen, review weight over time and decide whether a dietitian or a swallowing evaluation would help. Gateway can arrange primary care in the same home or facility where wound visits take place, so the clinician who orders the dressing and the clinician who looks at nutrition are working from the same information.
Arranging pressure injury care in Maryland Heights
To arrange pressure injury care in Maryland Heights, call Gateway at 314-325-0126. Patients, family members and caregivers can call directly, and a referral is not required. We will ask where the patient lives, what has been done for the wound so far and which clinicians are involved. Gateway then confirms whether a partner clinician is available for that address and care setting, requests the relevant records and schedules the visit. At that visit the treating clinician examines the wound and decides on the plan. Our job from then on is the coordination: orders, supplies, follow-up visits and keeping the care team informed.
For a Maryland Heights address, tell us the nearest major road, such as Dorsett Road, McKelvey Road or Page Avenue, along with the apartment or unit number if there is one. Have a callback number, the regular doctor’s name and the date of any recent hospital stay. Gateway also arranges care in Creve Coeur, Bridgeton, Overland, Hazelwood, and Chesterfield and West County. Highway access here is good, but visit days are still set according to the care setting and the partner clinician’s schedule.
- County: St. Louis County, Missouri
- ZIP codes: 63043
- Nearby hospitals: Mercy Hospital St. Louis in Creve Coeur; Barnes-Jewish West County Hospital in Creve Coeur; SSM Health DePaul Hospital in Bridgeton (not affiliated with Gateway)
- Nearby communities: Creve Coeur, Bridgeton, Overland, Chesterfield and West County, Hazelwood
- Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation
Related care in Maryland Heights
Read the full guide to pressure injuries, or see everything Gateway arranges on the mobile wound care in Maryland Heights page.
- Diabetic foot ulcers
- Venous leg ulcers
- Arterial and mixed wounds
- Non-healing wounds
- Post-surgical wounds
- Reopened (dehisced) surgical wounds
- Surgical site infections
- Skin tears and traumatic wounds
- Wounds with lymphedema
- Skin graft aftercare
- Wound VAC (NPWT) follow-up
- Pressure injury and bed sore care in Creve Coeur
- Pressure injury and bed sore care in Chesterfield and West County
- Pressure injury and bed sore care in Hazelwood
Common questions
Will insurance pay for pressure injury care or a special mattress in Maryland Heights?
It depends on the plan, the treating provider and the care that is needed. You can ask us about Medicare, Medicare Advantage, Medicaid and commercial plans, and we will help you find out what applies before a visit. Equipment such as a support surface usually requires a clinician’s order and supporting documentation, and each plan sets its own rules.
What should we have ready before the first wound care visit?
Have a current medication list, any hospital or rehab discharge papers, the insurance cards and the dressings you are using now. Write down when the sore was first noticed and how it has changed. Jot down your questions too, including who to call between visits. If several people share caregiving, try to have the main helper present to hear the plan.
How do we start pressure injury care for a family member in Maryland Heights?
Call Gateway or send the request form with a name and phone number only. You do not need a referral to call. On the phone we will ask where the person lives, how long the sore has been there, which hospital or doctor has seen it and what insurance they have. From there we gather records and work on scheduling with a partner clinician.
Can skilled nursing and rehab centers in Maryland Heights refer residents to Gateway?
They can. Directors of nursing, wound nurses and social workers at facilities in Maryland Heights may refer residents by phone at 314-325-0126 or by fax at 314-786-7966. Gateway arranges partner clinician visits at the facility and coordinates orders, supplies and documentation with staff. The treating clinician makes the clinical decisions, and the facility’s team continues the daily care.
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.