About skin tears and traumatic wounds

Skin tears are seen most often in the oldest adults, but age is only part of the picture. The risk climbs for anyone who needs hands-on help to bathe, dress or move from bed to chair, because every assist puts force on the skin. It climbs again for people with memory loss, poor eyesight or unsteady balance, who bump into things and may not mention it. Swollen legs, a poor appetite and low fluid intake add to it, as do certain long-term medicines. One of the clearest warnings is a previous skin tear, since the conditions that caused the first are usually still there. Younger adults are not exempt. Serious illness and long hospital stays can leave skin just as fragile.

What the treating clinician looks at

Much of the care plan for a skin tear comes down to what touches the wound and how it is held there. The treating clinician generally chooses a dressing with a gentle contact surface, one that can stay on for several days and release without lifting the flap or the skin around it. The clinician also decides how it is secured, often with a soft wrap or sleeve in place of tape, and who will change it. Past reactions to adhesives are worth mentioning at this point. Pain is part of the assessment too. A dressing change that hurts is looked into, because it can point to a dressing that sticks, to swelling or to infection.

Arranging this care in O’Fallon

On the Illinois side of the river, an injury is usually first treated at an Illinois hospital or urgent care, and the insurance behind it may be an Illinois Medicaid plan or a Medicare Advantage plan with its own provider list. Before a wound visit is scheduled in O’Fallon, Gateway confirms which partner clinician can see the person in Illinois and helps the family raise the right questions with the plan. A fresh skin tear should not be left waiting on paperwork, so call once the injury has been seen. We request the hospital records in the meantime.

O’Fallon, Illinois is a St. Clair County city on Interstate 64, with Shiloh to the south, Fairview Heights to the west and Lebanon farther east. Scott Air Force Base is nearby, and many households have a tie to it, from active-duty families to retirees who decided to stay. The city has grown outward from its old downtown into wide areas of newer subdivisions. Even with a hospital in town, regular trips for wound care or follow-up visits are tiring for someone who is recovering or frail, and care arranged at home or in a facility spares them that.

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

Care in skilled nursing and assisted living

In a skilled nursing facility, a skin tear is usually found by an aide or nurse during morning care or after a transfer. The facility documents it, notifies the attending physician and the family, and can refer to Gateway for a wound care visit. The treating clinician assesses the resident at the bedside and writes orders that facility nurses carry out between visits. Findings go back to the attending physician, the director of nursing and the wound nurse, so the chart tells one consistent story. Because many tears happen during bathing, dressing and repositioning, the clinician can also advise on handling and protective measures for that resident.

Signs to tell the clinician about

Infection is the complication clinicians watch for most closely after a skin injury. Report these to the treating clinician or the facility nurse promptly:

  • Redness that is spreading outward from the wound
  • Skin around it that feels hot, hard or newly swollen
  • Thick, cloudy or foul-smelling drainage
  • Pain that is rising instead of easing
  • Fever, chills or feeling generally unwell

Call 911 if the person becomes confused, very drowsy, short of breath or faint, with or without a fever. Those can be signs that an infection is affecting the whole body and cannot wait for a scheduled visit.

Why primary care matters here

Below the knee, a traumatic wound is rarely only about the skin. Fluid from heart, kidney or vein problems collects in the lower legs, stretches the skin and seeps through any break in it. Narrowed arteries deliver too little blood to rebuild tissue. Both are long-term conditions that belong to primary care and, where needed, to heart or vascular specialists. The wound clinician may be the first to notice them. With both kinds of care arranged through Gateway, that observation can become a referral, a test or a treatment change handled by the right clinician, and the wound plan is updated when the answers come back.

Primary care at home in O'Fallon →

Getting care arranged in O’Fallon

You may already have a surgeon, a wound clinic or a home health nurse and still want help with skin tear and traumatic wound care closer to home in O’Fallon. That is a fine reason to call 314-325-0126. Tell us who is treating the wound now and what is not working, whether that is the travel, the gaps between appointments or unclear instructions. Gateway does not replace your current clinicians. We can arrange for a partner clinician to see the wound where you live and, with your permission, share notes with the offices already involved so the plans agree.

HSHS St. Elizabeth’s Hospital is here in O’Fallon, and Memorial Hospital Shiloh is just over the city line. Gateway is not affiliated with either one. With two hospitals this close, the ride home after a stay is short, but the questions about what happens next are the same as anywhere. A relative can call us before discharge day to ask about follow-up, and discharge planners can refer by phone or fax. We request the summary and orders, confirm whether the patient is going home or to a facility, and arrange a visit with a partner clinician.

Related care in O’Fallon

Read the full guide to skin tears and traumatic wounds, or see everything Gateway arranges on the mobile wound care in O'Fallon page.

Common questions

Can a clinician come to a home in O’Fallon 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.

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.

How is a skin tear different from an ordinary cut?

A cut is made by something sharp and usually has clean edges that go straight down. A skin tear is made by rubbing, bumping or pulling, and it peels the top layer of skin sideways, often leaving a thin flap. Skin tears tend to be shallow but wide, and they happen on skin too delicate for some of the closures used on cuts. That is why they are assessed and dressed differently.

Is this information for O’Fallon, Illinois or O’Fallon, Missouri?

This information is for O’Fallon in St. Clair County, Illinois, ZIP code 62269. There is also an O’Fallon in St. Charles County, Missouri, and the two are easy to confuse. When you call 314-325-0126, give the state and ZIP code along with the street address so the request is matched to the correct location. Availability is confirmed by location and care setting.

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.