About wound VAC therapy

People on a wound VAC have usually just been through something significant. Many are recovering from abdominal, orthopedic, vascular or foot surgery where the incision opened or was left open on purpose. Others have a deep pressure injury over the tailbone or hip, a diabetic foot wound that needed surgical cleaning, or a wound from an accident.

Because of that, the therapy often starts in a hospital and then follows the person to a rehabilitation center, a skilled nursing facility or home. The same person may be weak, eating poorly, or living with diabetes or poor circulation. Those facts shape how closely the wound and the device need to be watched after discharge.

What the treating clinician looks at

The treating clinician looks past the wound to the person wearing the device. Is pain at dressing changes controlled well enough that changes happen on time? Can the person walk safely with the tubing, sleep, and keep the pump charged? Is a bed, chair or shoe pressing on the wound in a way suction cannot overcome? These answers count as much as the measurements.

The clinician also plans the exit early: what the wound should look like when the pump comes off, what dressing will replace it and whether a surgeon will close or graft the wound. Knowing the end point helps everyone judge whether each visit shows movement toward it.

Local context: North St. Louis

In an apartment or an older multi-story home in North St. Louis, the pump goes wherever you go, including up the stairs. Plan how you will carry the case and tubing before the first climb, and think about setting up a bed and charger on one floor for now. Supply boxes are another city problem: canisters and dressing kits left in a shared lobby can go missing, so ask the supplier about delivery instructions. When we schedule a visit, we ask about buzzers, door codes and parking so the clinician arrives in time for the dressing change.

The housing here is mostly brick: two-story single-family homes, two-family and four-family flats, and senior apartment buildings, usually with steps up to the front door. Second-floor flats and steep stairs are a real obstacle for someone with a leg wound or poor balance. Skilled nursing facilities and assisted living are part of the picture too. Gateway arranges partner clinician visits in any of these settings. When you call, tell us about the steps, which door to use and whether someone will be home, so the visit can start without delays.

At home between visits

Between nursing visits, the household keeps the therapy running. That mostly means ordinary habits: plug the pump in overnight, keep the tubing free of kinks and out from under the body, glance at the canister a few times a day and keep the carrying case off the floor.

A short log helps the clinician: when alarms sounded, when the canister was swapped and anything that looked different. Post the home health agency’s number and the device support line where everyone can find them. Family members are not asked to pack the wound. Ask the nurse to show you exactly what to do if the seal is lost.

Care in skilled nursing and assisted living

Assisted living and memory care communities often do not have nurses who change negative pressure dressings, so a home health agency usually comes in for that, much as it would in a private home. Staff still need the basics: what the alarms mean, where the tubing should sit and who gets the call.

In memory care, a resident may tug at the tubing, peel the film or forget the pump when standing up. The treating clinician weighs that honestly and sometimes decides a different dressing is safer. Gateway keeps the community’s staff, the agency, the family and the clinician working from one current set of orders.

What to report and when to call 911

Some problems belong to the device, and they still deserve a prompt call to the nurse or treating clinician, because a pump that is off has stopped helping:

  • An alarm that keeps returning after the tubing and canister have been checked
  • A dressing that is no longer firm and drawn down
  • A hissing sound, or a film edge that will not stay stuck
  • A pump that will not charge or turn on
  • Fluid leaking from under the film

Bleeding is different. If bright red blood is filling the tubing or canister, call 911 and follow the emergency steps in the instructions that came with the pump.

Primary care and overall health

Suction cannot make up for what the bloodstream does not deliver. High blood sugar slows repair and raises infection risk, and narrowed arteries in the legs can leave a foot wound short of the oxygen it needs. If a wound on negative pressure therapy is not shrinking, the treating clinician often wants to know how diabetes is being managed and whether circulation has been tested.

Primary care is where those threads are followed: glucose records, medication review, referrals for vascular studies. Arranging both kinds of care through one coordinator means the wound clinician’s question reaches someone who can act on it.

Primary care at home in North St. Louis →

How to get started in North St. Louis

Clinicians and facility staff referring a patient for wound VAC follow-up in North St. Louis can call 314-325-0126 or fax 314-786-7966. Helpful to include: demographics and insurance, the working diagnosis, recent wound notes and measurements, current orders, the medication list and relevant test results. Please also tell us who should receive the treating clinician’s notes afterward. The online referral form takes contact details only, so clinical records should come by fax, not through the form. Gateway confirms that the referral arrived, checks availability for the patient’s address and lets your office know what has been scheduled.

Have these ready when you call 314-325-0126: the patient’s name, street address and ZIP code, a main phone number and a backup, and the name of any doctor or health center they use. If the patient stays with different relatives during the week, say so. Gateway also arranges care elsewhere in the City of St. Louis, including Downtown and the Central West End, and across the line in Ferguson and North County. Visit availability is confirmed for each address, and a reachable phone number keeps scheduling on track.

  • County: City of St. Louis, Missouri (an independent city)
  • ZIP codes: 63106, 63107, 63113, 63115, 63120, 63147
  • Nearby hospitals: Barnes-Jewish Hospital; SSM Health Saint Louis University Hospital; Christian Hospital in North County (not affiliated with Gateway)
  • Nearby communities: St. Louis City, Downtown St. Louis, Central West End, Ferguson, North County
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

More wound care in North St. Louis

Read the full guide to wound VAC therapy, or see everything Gateway arranges on the mobile wound care in North St. Louis page.

Common questions

Can a clinician come to a home in North St. Louis to follow a wound VAC?

That is the kind of visit Gateway arranges. A partner clinician examines the wound, reviews how the therapy is going and updates the orders, ideally timed with a dressing change. Visit availability is confirmed by location and care setting, so we check your address and situation first. Call 314-325-0126, with or without a referral. The home health nurse and equipment supplier you already have can usually stay in place.

Why does the dressing look wrinkled and feel hard?

That is how a working dressing looks. When the pump is running and the seal is airtight, the foam under the film shrinks down and feels firm, a bit like a vacuum-packed bag. If the dressing turns soft, smooth or puffy, suction has probably been lost. Check that the pump is on and the tubing is connected, then call your nurse if it does not draw back down.

Can I sleep normally with a wound VAC?

Most people do, with a little setup. Put the pump on a stable surface where your instructions say it should sit, plug it in so it charges overnight, and route the tubing so you will not lie on it or catch it when you turn. If the wound is over the tailbone or hip, ask the clinician which positions to avoid. Tell the nurse if alarms keep waking you, since a recurring leak can often be fixed.

What if the patient’s phone number changes or they move within North St. Louis?

Call us with the new information as soon as you can. Visits are arranged by address, so a move, even a few blocks, needs to be updated before the next visit. If the patient’s phone is out of service, give us a relative’s or neighbor’s number as a backup. Keeping contact details current is the simplest way to avoid a missed visit.

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.