About skin tears and traumatic wounds

Young skin is anchored. Its outer and inner layers lock together with small ridges, a little like two egg cartons stacked. Over the decades those ridges flatten, the skin makes less collagen and natural oil, the cushion of fat beneath thins out, and small blood vessels grow brittle. The result is skin that slides, splits and bruises under forces a younger person would never notice. Most of those forces come from ordinary life: a hand gripping an arm during a transfer, a bed rail, a walker frame, a watch band, a pet’s claws, a fingernail, or a strip of tape peeled away. Dryness and years of sun make matters worse, which is one reason tears cluster on the forearms and the backs of the hands.

What the treating clinician looks at

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.

Skin tear and traumatic wound care in Mehlville

Many houses in Mehlville 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.

Mehlville is not a city with its own city hall. It is an unincorporated part of South County, governed by St. Louis County, with mail addressed to St. Louis. Lemay Ferry Road runs through the middle of it, Interstate 55 passes alongside, and Lindbergh Boulevard and the interchange with Interstates 255 and 270 are close by. The neighborhoods are settled, and many households have been here for a generation or more. As those residents get older, wound care and primary care arranged at home or in a local facility become a practical way to stay put.

At home between visits

Family caregivers do the daily handling that fragile skin either withstands or does not. A home visit is a good time to ask the treating clinician to watch a transfer, look over the wheelchair or walker, and point out what to change. Common suggestions include:

  • Padding on bed rails, table edges and wheelchair leg rests
  • Long sleeves, long pants, or soft sleeves made to protect shins and forearms
  • Supporting a limb from below with open palms, not gripping it
  • Short fingernails and no rings or watches during care
  • A plain moisturizer on arms and legs every day
  • Clear, well-lit paths, above all at night

In a facility

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.

What to report and when to call 911

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.

Primary care and overall health

Skin is built from what a person eats and drinks. Older adults who have lost their appetite, lost weight or drink little often have dry, slow-healing skin, and a wound raises the body’s need for protein and fluid. Diabetes adds another layer, since high blood sugar slows repair and makes infection more likely. A primary care clinician can check weight trends, order lab work where appropriate, review blood sugar and suggest a dietitian if that fits. These are slow fixes, so they help most when started early. Arranging primary care alongside wound visits means the body’s side of healing gets attention while the dressing does its part.

Primary care at home in Mehlville →

How to get started in Mehlville

To arrange skin tear and traumatic wound care in Mehlville, 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.

Mercy Hospital South is the hospital most Mehlville families know, and it is where many local patients are admitted and discharged. Gateway is not affiliated with it. If you or a relative is leaving the hospital with a wound that needs ongoing care, you can call us to ask about follow-up at home. Case managers and social workers can refer directly by phone or fax. We ask for the discharge summary, the current wound orders and a contact at the home, then confirm a partner clinician’s availability for that Mehlville address.

  • County: St. Louis County, Missouri
  • ZIP codes: 63125, 63129
  • Nearby hospitals: Mercy Hospital South (not affiliated with Gateway)
  • Nearby communities: Oakville, Affton, South County, Arnold, South St. Louis
  • 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 Mehlville page.

Common questions

Can a clinician come to a home in Mehlville 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.

Will insurance pay for traumatic wound care at home in Mehlville?

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.

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.

Mehlville is unincorporated. Does that change how Gateway arranges care there?

No. Gateway arranges care by address and care setting, not by city limits. Mehlville homes and facilities in 63125 and 63129 are part of the South County area we cover. Because the mailing address reads St. Louis, mention Mehlville or a nearby main road such as Lemay Ferry Road when you call, so the partner clinician’s office knows exactly where the visit will be.

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.