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.

How the care plan is built

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.

Local context: Oakville

People in Oakville with a pressure injury often move between settings: home, a hospital stay, a few weeks of rehabilitation, then perhaps assisted living or skilled nursing close by. Each move brings a new bed, new caregivers and a risk that the turning plan and wound orders get lost. Gateway arranges wound care in private homes and in senior living and nursing facilities across Oakville, and helps the latest measurements and orders travel with the person.

At the southern tip of St. Louis County, Oakville sits on a wedge of land with the Mississippi River on the east and the Meramec River wrapping around the south and west. Telegraph Road is the main road, and most trips out lead north toward Interstate 255 or Interstate 55. It is an unincorporated community of subdivisions, parks along the river bluffs and families who tend to stay. The same geography that keeps Oakville quiet also puts it at the far end of the drive to most medical appointments, which is why care at home matters here.

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.

Care in skilled nursing and assisted living

People often arrive at a rehabilitation center with a pressure injury that began in the hospital, or with fragile skin after surgery and days in bed. Therapy adds a new question: how long can the person sit in a wheelchair or on a mat without harming the wound? The treating clinician, nursing staff and therapists work that out together.

Rehab stays are short, so planning for what comes next begins early. Gateway can help arrange for wound care to continue after discharge, whether the person goes home or to another facility, so that orders, records and supplies follow them and care does not start over.

Changes to report

An infected pressure injury can make the whole body sick, and in frail older adults the first sign is often a change in behavior, not a change in the wound. Contact the treating clinician promptly about:

  • Fever or shaking chills
  • Redness, warmth or swelling spreading out from the wound
  • Pus or cloudy drainage
  • Pain that is new or clearly worse
  • New confusion, unusual sleepiness or refusing food and drink

Call 911 if the person is very confused or unresponsive, is breathing fast or with difficulty, or looks suddenly and seriously ill.

Why primary care matters here

Several everyday medical issues affect how much pressure the skin takes. Medications that cause drowsiness can reduce the small movements a person makes while sitting or sleeping. Untreated pain makes people hold still and resist turning. Diarrhea, urinary infections and constipation with leakage keep skin wet. Stiff, contracted joints limit the positions a person can use.

A primary care clinician can review the medication list, pain control, bowel and bladder problems and whether therapy would help with mobility. Do not stop or change a medication on your own. Bring the concern to the clinician, and ask Gateway to share it with the wound care team as well.

Primary care at home in Oakville →

Getting care arranged in Oakville

Setting up pressure injury care for someone in Oakville 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.

Call 314-325-0126 with the patient’s Oakville address, phone number, date of birth and doctor’s name, and tell us about any recent hospital or rehabilitation stay. Mailing addresses here say St. Louis, so mention Oakville or the 63129 ZIP code. Gateway also arranges care in Mehlville, the rest of South County, and across the Meramec River in Arnold and Imperial. Oakville is tucked between two rivers, with only a few roads in and out, so visit days are confirmed by location.

  • County: St. Louis County, Missouri
  • ZIP codes: 63129
  • Nearby hospitals: Mercy Hospital South (not affiliated with Gateway)
  • Nearby communities: Mehlville, Arnold, South County, Imperial
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Other conditions and nearby communities

Read the full guide to pressure injuries, or see everything Gateway arranges on the mobile wound care in Oakville page.

Common questions

Can a wound care clinician come to a home in Oakville to look at a bed sore?

Gateway arranges home visits by partner clinicians for people with pressure injuries, and availability is confirmed by location and care setting. When you call 314-325-0126, we ask for the address, whether the person is at home or in a facility, and who is already involved in their care. We then tell you what can be arranged for that address.

Can sitting in a wheelchair or recliner cause a pressure injury?

Yes. Sitting puts much of the body’s weight on a small area under the sitting bones and tailbone, so pressure injuries can form in a chair as readily as in a bed. People who sit most of the day need a suitable cushion and regular changes of position. The treating clinician can advise on the cushion and on how long the person should sit at a stretch.

What is debridement, and will my family member need it?

Debridement means removing dead tissue from a wound so healthy tissue can grow and infection is less likely. There are several methods, some using dressings or ointments and some done by a clinician with instruments. Not every pressure injury needs it, and in some situations it is avoided. The treating clinician decides whether, when and how, and will explain the reasons.

Does Gateway arrange care for people leaving rehab and returning home to Oakville?

Yes. The move from a rehabilitation center back to an Oakville home is a good time to call. Tell us the planned discharge date and the name of the rehab facility’s social worker or nurse. With permission, Gateway requests the wound notes and orders from the facility, so the treating clinician can see what the rehab team was doing and the family does not have to carry paperwork between them.

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.