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 an assessment covers

A pressure injury care plan depends on the whole person, so the treating clinician reviews more than the skin. Expect questions about how much the person can move without help, whether they can feel and report discomfort, how often skin is exposed to moisture, and how well they have been eating and drinking.

The clinician also asks what the person and family want from care. For one person the aim is to close the wound. For another, who is very frail, the aim may be to keep the wound stable, clean and comfortable. Being honest about what caregivers can manage each day helps the clinician write a plan that will be followed.

Pressure injury and bed sore care in St. Clair County

Some people in St. Clair County have long crossed the river to St. Louis for specialty care. With a pressure injury, that trip means extended sitting in a car and then a clinic chair, which works against the wound. Gateway can check whether a partner clinician is available to visit the home or facility on the Illinois side instead. Coverage and the treating provider are confirmed before the visit, and records from hospitals in either state are gathered for the clinician.

St. Clair County begins at the Mississippi riverfront in East St. Louis and Cahokia Heights, climbs the bluffs to Belleville, the county seat, and continues through Swansea, Fairview Heights, O’Fallon and Shiloh out to Mascoutah, Lebanon and Freeburg. Interstate 64 and Illinois Route 15 carry much of the traffic. The county holds some of the oldest neighborhoods in the Metro East and some of the newest, and in all of them there are people who cannot get to a clinic easily. Arranging wound care and primary care where they live is the practical answer.

At home between visits

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

Assisted living communities are not staffed like nursing homes, and that shapes pressure injury care. Aides may help with bathing and transfers, but skilled dressing changes are often done by a visiting home health nurse or, where the community’s license allows, by its own nurse.

When Gateway arranges a wound visit in assisted living, we ask early who handles each part: dressing changes, repositioning, incontinence care and equipment. The treating clinician’s orders are shared with the community’s nurse or director, the home health agency if one is involved, and the family. A resident who now needs far more hands-on help may prompt a wider talk about the level of care.

Signs to tell the clinician about

Once a pressure injury is being cared for, the treating clinician needs to hear about changes in the wound between visits. Report any of these:

  • The wound looks wider or deeper than it did at the last visit
  • Black, brown, gray or thick yellow tissue appears
  • Drainage increases, soaks through the dressing or changes color
  • A new or stronger odor that remains after the wound is cleaned
  • The edges lift or a pocket seems to open under the skin

Call 911 for bleeding from the wound that will not stop, or if the person collapses or cannot be roused.

Why primary care matters here

Tissue under pressure survives on blood flow, so anything that reduces circulation or the oxygen carried in the blood makes a pressure injury more likely and harder to close. Diabetes, peripheral artery disease, heart failure, chronic lung disease and anemia are common examples. Heels are especially sensitive to poor circulation in the legs.

These conditions are managed in primary care. When the wound clinician and the primary care clinician can see each other’s notes, a wound that has stalled can prompt a fresh look at blood sugar, circulation or blood counts. Gateway arranges both kinds of visits and helps keep records moving between them.

Primary care at home in St. Clair County →

Getting care arranged in St. Clair County

Setting up pressure injury care for someone in St. Clair County 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.

St. Clair County requests start with the town and ZIP code, since Belleville alone has several. Keep the patient’s phone number, medication list, insurance card and doctors’ names nearby when you call. Gateway arranges care in Belleville, O’Fallon, Fairview Heights and neighboring Collinsville, and across the wider Metro East. The county runs from city blocks near the river to open farmland in the east, and availability is confirmed for each location and care setting before a visit is scheduled.

  • County: St. Clair County, Illinois
  • ZIP codes: 62220, 62221, 62223, 62226, 62269, 62208, 62258, 62254
  • Nearby hospitals: Memorial Hospital Belleville; Memorial Hospital Shiloh; HSHS St. Elizabeth's Hospital in O'Fallon, Illinois; Touchette Regional Hospital in Cahokia Heights (not affiliated with Gateway)
  • Nearby communities: Belleville, Illinois, O'Fallon, Illinois, Fairview Heights, Collinsville, Metro East
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Related care in St. Clair County

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

Common questions

Does Gateway work with nursing homes and assisted living communities in St. Clair County?

Yes. Gateway arranges for partner clinicians to see residents with pressure injuries in skilled nursing, assisted living, memory care and rehabilitation settings, either one resident at a time or through regular wound rounds. Facility staff can refer a resident, and families can ask the facility to contact us. Availability for a specific building is confirmed when the request comes in.

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.

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.

My father lives in a memory care community in St. Clair County. Can wound care come to him there?

Yes, Gateway arranges visits in memory care. Being seen in a familiar room with familiar staff nearby can make an assessment easier for a person with dementia. We coordinate with the staff on a good time of day for your father, and the treating clinician leaves orders the staff can follow. As his family, you can ask to be updated after visits.

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.