Understanding non-healing wounds

Anyone can have a wound that stalls, but some people are more likely to. Older adults are seen most often, because skin thins with age and repair slows. People living with diabetes, vein disease, narrowed leg arteries, heart failure or kidney disease are also common, since each condition affects blood flow, swelling or the body’s ability to rebuild tissue.

Limited mobility raises the odds too. Someone who spends most of the day in a wheelchair, recliner or bed puts steady pressure on the same areas. People who have lost feeling in their feet may not notice a shoe rubbing until the skin has broken. People who smoke, people recovering from a long hospital stay and people who are eating very little also turn up often with wounds that will not close.

How the care plan is built

The treating clinician usually begins with the story before looking at the wound. When did it start, and from what? Has it ever closed? Which dressings, antibiotics, wraps or devices have been used, for how long, and what happened with each one? Old measurements and photos are especially useful, because they show direction.

With that timeline in hand, the clinician examines the wound and the limb or body area around it, then decides what is still unexplained. The care plan that follows is built around the likely cause, not around a product. It names what will change, who will do each part between visits, and when the wound will be measured again.

Non-healing wound care in South County

People in South County often move between home, a nearby rehabilitation unit and a senior living community as their health changes, and a chronic wound travels with them. Each move risks a different dressing, a lost measurement history and a new set of nurses starting from zero. Gateway keeps the wound’s history together across those settings and arranges for a treating clinician to follow it where the person is staying, when availability allows. If an adult child nearby helps with dressings, we include them in scheduling and updates when the patient agrees.

South County is shorthand for the southern part of St. Louis County, a band of communities roughly south of Interstate 44 that reaches from the River des Peres at the city line down to the Meramec River. It includes Affton, Lemay, Mehlville, Oakville, Concord, Sappington, Green Park, Crestwood and Sunset Hills. Gravois Road, Tesson Ferry Road, Lemay Ferry Road, Telegraph Road and Lindbergh Boulevard are the roads everyone uses. People here tend to stay for life, and many are retirees. Bringing wound care and primary care to them fits the way South County lives.

Care at home

Most of the work on a slow wound happens between visits. Dressings are changed on the schedule the clinician ordered, by the patient, a family member or a visiting nurse. Someone keeps an eye on the drainage and the skin around the wound. Leg elevation, pressure relief or wraps are kept up day after day.

Gateway helps keep that routine from breaking down. We ask whether the dressing is manageable, relay questions to the treating clinician and schedule the next visit. If something changes, such as a hospital stay or a new caregiver, tell us so the plan and the visit schedule can be revisited.

Care in skilled nursing and assisted living

For a resident in memory care, a wound that will not heal often has a behavioral side. The person may pull off dressings, scratch at the area, pace for hours on swollen legs, or be unable to say that something hurts. Staff who know the resident usually know these patterns well.

The treating clinician takes that knowledge into account when choosing dressings and how they are secured, and may suggest timing care for the calmest part of the resident’s day. A familiar staff member or relative at the visit helps. Gateway arranges those details ahead of time and updates the family or legal decision-maker afterward.

What to report and when to call 911

Not every change is an emergency, but these deserve a prompt call to the treating clinician’s office:

  • Red streaks running up the arm or leg from the wound
  • Pus, or drainage that turns green, tan or cloudy
  • Home blood sugar readings well above your usual range
  • Numbness, tingling or new swelling below the wound
  • A wound that had closed and has opened again

If you cannot reach the office and you are worried, go to urgent care or an emergency department. Call 911 right away for spurting or uncontrolled bleeding, chest pain or pressure, difficulty breathing, or a limb that suddenly turns cold and discolored.

Why primary care matters here

Some people with a long-standing wound have not seen a primary care clinician in a long while. Getting to an office may be the obstacle: stairs, a wheelchair, no ride, or a wound that leaks through its dressing on the way. Meanwhile blood pressure, weight, mood, sleep, tobacco use and mobility go unreviewed, and each has a hand in how skin repairs.

Gateway can arrange primary care in the same settings as wound care, including at home. One coordinated plan means fewer conflicting instructions and one place to call with questions. Each clinician still makes the decisions in their own area.

Primary care at home in South County →

Getting care arranged in South County

Setting up non-healing wound care for someone in South 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.

Mercy Hospital South is the hospital most South County residents know best. SSM Health St. Clare Hospital in Fenton and St. Luke’s Des Peres Hospital are used by many people on the western and northwestern sides. None of them is affiliated with Gateway. For discharge planners, a referral by phone or fax with the summary, wound orders and a family contact is enough to start. For families, one call to 314-325-0126 before or after discharge works. We then look for a partner clinician for the patient’s home or facility and confirm what happens next.

  • County: St. Louis County, Missouri
  • ZIP codes: 63123, 63125, 63126, 63127, 63128, 63129
  • Nearby hospitals: Mercy Hospital South; SSM Health St. Clare Hospital in Fenton; St. Luke's Des Peres Hospital (not affiliated with Gateway)
  • Nearby communities: Affton, Mehlville, Oakville, Crestwood, Sunset Hills, Fenton
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

More wound care in South County

Read the full guide to non-healing wounds, or see everything Gateway arranges on the mobile wound care in South County page.

Common questions

How often will someone visit for a wound that is not healing in South County?

The treating clinician sets the visit schedule based on the wound, the plan and who is changing dressings between visits. Chronic wounds are usually rechecked on a regular cycle so measurements can be compared, and the interval may change as the wound does. Gateway confirms what is available for your location and care setting and lets you know the schedule ahead of time.

What if my wound closes and then opens again?

A wound that reopens in the same place usually means the original cause is still present. New skin over a healed wound is weaker than the skin around it, so returning pressure, swelling or friction can break it down. Tell the treating clinician how long it stayed closed and what changed beforehand. Ongoing protection of the area is often part of the plan after closure.

Can a clinician come to a home in South County to look at a wound that will not heal?

In many cases, yes. Gateway arranges home visits with partner clinicians across Greater St. Louis and the Metro East, and we confirm availability for your exact address and care setting before scheduling. Call 314-325-0126 or send a request with a name and phone number. You do not need a referral to ask, and a family member can call for you.

What areas does Gateway mean by South County?

We use South County the way most St. Louisans do: the southern part of St. Louis County, including Affton, Lemay, Mehlville, Oakville, Concord, Sappington, Green Park, Crestwood and Sunset Hills. That covers ZIP codes 63123, 63125, 63126, 63127, 63128 and 63129. Fenton and Arnold are nearby and are covered as well. Availability is confirmed for each address 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.