Understanding non-healing wounds
Several common beliefs about slow wounds do not hold up. One is that a wound should be left open to the air to dry out and scab. For most chronic wounds clinicians aim for a moist, protected surface instead, though the choice of dressing is theirs to make. Another is that no pain means no problem. People with nerve damage can have a serious wound and feel almost nothing.
A third mistake is treating a wound that will not heal as a normal part of getting older. Age slows repair, but age alone does not keep a wound open. And many families assume a stronger cream is the missing piece, when the real barrier is pressure, swelling or blood flow that no ointment can correct.
What an assessment covers
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 St. Louis
In South St. Louis, many people with a slow wound live in upper-floor apartments or tall older houses with steep stairs. Each trip down for an appointment puts weight on a foot ulcer or leaves a swollen leg hanging, and some people simply stop going. A reassessment at home removes that trip. Before the visit, Gateway asks about building entry, buzzer codes, elevators, parking and where supply deliveries can be left safely. The large medical centers nearby remain the place for vascular testing or specialty procedures when the treating clinician orders them.
South St. Louis means the city neighborhoods generally along and south of Interstate 44: Tower Grove, Dutchtown, Carondelet, The Hill, Soulard, St. Louis Hills and many more, each with its own corner shops, churches and parks. Grand Boulevard, Gravois Avenue, Kingshighway and Hampton Avenue carry the traffic, and Tower Grove Park and Carondelet Park anchor the map. People here are loyal to their blocks. An older resident may have lived within a mile of the same parish all their life, and care at home lets that continue when getting out becomes difficult.
When care happens at home
Family caregivers often carry a non-healing wound for months: changing dressings before work, washing linens, worrying about every new stain on the bandage. If that is you, plan to be present for the visit, in person or by phone. The treating clinician can show you what they are seeing and explain the dressing routine in plain terms.
Say honestly what you can and cannot do. A plan that calls for daily changes will fail if nobody is home during the day. The clinician can often choose an approach that fits the help available, or consider whether home health nursing is appropriate.
Care in skilled nursing and assisted living
Assisted living communities are not set up like nursing homes. Staff may help with medications and bathing but are often limited in the wound care they can provide, so a resident with a stalled wound can fall between services. Dressing changes may depend on a visiting home health nurse, a family member or the resident.
Gateway helps sort out who is doing what. We arrange the partner clinician’s visit to the resident’s apartment, find out what the community’s staff can assist with, and coordinate with any home health agency involved. The resulting plan is written for the help that is really available.
Changes to report
If you care for someone who cannot describe how they feel, you are the early warning. Let the treating clinician know about:
- Guarding, flinching or crying out when the area is touched
- Less interest in eating or drinking
- New restlessness, sleepiness or confusion
- A swollen limb, especially on one side only
- Stains on bedding or clothing from drainage or blood
Write down the date you first noticed the change and mention it when you call. Do not wait on an emergency. Call 911 for bleeding you cannot control, fainting, a seizure, severe shortness of breath or sudden weakness on one side of the body.
How primary care fits in
Blood sugar is one of the strongest links between general health and a wound that will not close. When sugar runs high, the cells that fight infection and build new tissue work poorly, and small blood vessels deliver less. A wound clinician can choose the right dressing at every visit and still see little progress if diabetes control has slipped.
That is primary care territory: reviewing readings, lab results and the overall diabetes plan. When Gateway arranges both kinds of care, the wound findings reach the clinician managing the diabetes, and changes on that side are known to the wound care team.
Getting care arranged in South St. Louis
You may already have a surgeon, a wound clinic or a home health nurse and still want help with non-healing wound care closer to home in South St. Louis. 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.
South St. Louis patients are discharged from several hospitals, most often SSM Health Saint Louis University Hospital, Barnes-Jewish Hospital, SSM Health St. Mary’s Hospital in Richmond Heights and Mercy Hospital South. Gateway is an independent company and is not affiliated with any of them. Hospital social workers and case managers can refer a patient going home to the south side by phone or fax. Family members can call as well. We ask for the discharge summary and current wound orders, find out who helps the patient at home, and confirm a partner clinician’s availability for that neighborhood.
- County: City of St. Louis, Missouri (an independent city)
- ZIP codes: 63104, 63109, 63111, 63116, 63118, 63139
- Nearby hospitals: SSM Health Saint Louis University Hospital; Barnes-Jewish Hospital; SSM Health St. Mary's Hospital in Richmond Heights; Mercy Hospital South (not affiliated with Gateway)
- Nearby communities: St. Louis City, Downtown St. Louis, Affton, Shrewsbury, Maplewood, Central West End
- Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation
Related care in South St. Louis
Read the full guide to non-healing wounds, or see everything Gateway arranges on the mobile wound care in South St. Louis page.
- Diabetic foot ulcers
- Venous leg ulcers
- Pressure injuries and bed sores
- Arterial and mixed wounds
- Post-surgical wounds
- Reopened (dehisced) surgical wounds
- Surgical site infections
- Skin tears and traumatic wounds
- Wounds with lymphedema
- Skin graft aftercare
- Wound VAC (NPWT) follow-up
- Non-healing wound care in the City of St. Louis
- Non-healing wound care in Downtown St. Louis
- Non-healing wound care in Affton
- Non-healing wound care in the Central West End
Common questions
Is there someone in South St. Louis who can check a relative’s wound at an assisted living or nursing facility?
Gateway arranges visits in skilled nursing, assisted living, memory care and rehabilitation settings as well as private homes. If your relative lives in a facility in South St. Louis, call us with the facility name. We confirm availability for that location, coordinate with the nursing staff and attending physician, and keep you updated if you are the resident’s contact or decision-maker.
Could a wound that will not heal be skin cancer?
Occasionally, yes. Some skin cancers look like a sore that never closes, and a wound that has been open for a very long time can, rarely, change. It is not the usual explanation, but it is one reason clinicians take a second look at wounds that do not respond to care. The treating clinician may take a small tissue sample to check. Ask about it if you are worried.
How do I start non-healing wound care in South St. Louis if I do not have a referral?
Call 314-325-0126 or use the request form, which asks only for a name and phone number. Please leave medical details out of the form. We call back, ask about the wound, your location and the care setting, and confirm whether a partner clinician is available. With your permission we then request earlier records so the first visit is well informed.
Which South St. Louis neighborhoods does Gateway arrange care in?
Gateway arranges wound care and primary care across South St. Louis, including Tower Grove, Dutchtown, Carondelet, The Hill, Soulard and St. Louis Hills, and neighboring areas in ZIP codes 63104, 63109, 63111, 63116, 63118 and 63139. If your neighborhood is not named here, call 314-325-0126 with the address. Availability is confirmed for each 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.