Pressure injury and bed sore care in South St. Louis.

Understanding pressure injuries

Several common beliefs about bed sores are mistaken. One is that a small opening means a small wound. Pressure damage is often wider beneath the skin than at the surface, which is why clinicians measure depth and check under the edges.

Another is that rubbing a reddened area helps. Current guidance is to avoid massaging skin that already shows pressure damage. Ring or donut-shaped cushions are also a frequent mistake, because they can concentrate pressure around the edge of the ring. And a sore that does not hurt is not a mild one. Lack of pain may simply mean the person has lost feeling there. When in doubt, ask the treating clinician before trying a home remedy or a new cushion.

What an assessment covers

After the assessment, the treating clinician writes orders and explains them to the people who will carry them out. A pressure injury plan usually has several parts:

• Wound orders: how the wound is cleaned and covered, and how often the dressing is changed
• Pressure relief: the mattress, cushion or heel protection to use
• Positioning: which positions to use, which to avoid and how often to change
• Skin care: keeping the area clean and dry after incontinence
• Follow-up: when the wound will be checked again

Gateway follows up on the supply and equipment orders and shares the plan with the caregivers, home health nurses or facility staff involved.

Arranging this care in South St. Louis

In South St. Louis, getting pressure-relief equipment into the home can be the hardest step. A hospital bed or specialty mattress may have to come up a narrow staircase or through a small elevator, and many families end up setting the bed in a first-floor living or dining room. Tell Gateway about stairs, entry codes and where a visiting clinician can park. We pass those details along when scheduling so the visit and any deliveries are planned around the building.

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

Dressings are only part of what a pressure injury needs at home. The treating clinician may also order a pressure-redistributing mattress or overlay, a wheelchair cushion, heel protection or a hospital bed. Gateway follows up on those orders with suppliers and lets you know what to expect about delivery.

Dressings usually arrive in quantities meant to last until the next order. Check the box against what the clinician ordered, store it somewhere clean and dry, and tell us before the last few are used. Once equipment arrives, keep the instructions and the supplier’s phone number handy. Tell the clinician if a mattress feels flat, a cushion has shifted or the person will not tolerate it.

In a facility

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.

What to report and when to call 911

Pressure damage can start before the skin opens. Check the tailbone, hips, heels and other bony areas when you help with bathing or dressing, and tell the treating clinician or nurse if you see:

• A patch that stays red, purple, maroon or darker than nearby skin after the pressure is off
• Skin that feels warmer, cooler, firmer or softer than the skin around it
• A blister, a shiny area or a shallow break
• A spot the person says is sore, burning or itchy

Call 911 if the person has trouble breathing, chest pain, or is suddenly very hard to wake.

Why primary care matters here

The body builds new tissue from what a person eats and drinks, and a pressure injury raises the demand. Someone who has lost weight, eats only a few bites at meals, has trouble swallowing or has poorly fitting dentures may not be taking in enough protein, calories or fluid to keep up.

A primary care clinician can look for the reason appetite has fallen, review weight over time and decide whether a dietitian or a swallowing evaluation would help. Gateway can arrange primary care in the same home or facility where wound visits take place, so the clinician who orders the dressing and the clinician who looks at nutrition are working from the same information.

Primary care at home in South St. Louis →

Arranging pressure injury care in South St. Louis

Setting up pressure injury care for someone in South St. Louis 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.

When you call, name the neighborhood as well as the address, since South St. Louis covers a lot of ground and several ZIP codes. Tell us about stairs, a locked gate or a doorbell that does not work, and give a phone number that will be answered. Gateway also arranges care in Downtown St. Louis, the Central West End and the rest of the city, and in nearby Affton, Shrewsbury and Maplewood. Street parking and one-way blocks are part of visiting here, and visit days are confirmed by location.

• 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 pressure injuries, or see everything Gateway arranges on the mobile wound care in South St. Louis page.

• Diabetic foot ulcers
• Venous leg ulcers
• Arterial and mixed wounds
• Non-healing 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
• Pressure injury and bed sore care in the City of St. Louis
• Pressure injury and bed sore care in Downtown St. Louis
• Pressure injury and bed sore care in Affton
• Pressure injury and bed sore care in the Central West End

Common questions