Wound VAC and NPWT follow-up in the City of St. Louis.

About wound VAC therapy

Clinicians turn to negative pressure therapy when a wound is too deep, too wet or too large for ordinary dressings to manage well. A surgical incision that has come apart, a deep pressure injury, a foot wound after an operation or an injury with tissue loss can all produce more fluid than gauze or foam pads can hold, and the cavity left behind has a long way to fill in.

Suction under a sealed dressing removes that fluid continuously and encourages the healthy red tissue a wound needs before it can close. Sometimes the goal is full healing. Often it is narrower: get the wound clean, shallow and ready for stitches, a skin graft or a simpler dressing.

How the care plan is built

The device itself tells the treating clinician a good deal. How much fluid is in the canister, how often it has been replaced and what the fluid looks like all show how the wound is behaving between visits. Thin, pale or light pink fluid in decreasing amounts is generally reassuring.

The clinician also asks how the pump has been running: how many alarms, how long it was off, whether the seal has been hard to keep. Frequent leaks often point to a dressing problem that can be solved, such as a wound next to a skin fold or a joint. The care plan is then adjusted so the therapy actually runs for the hours it was ordered.

Wound VAC and NPWT follow-up in the City of St. Louis

Many people in the City of St. Louis start negative pressure therapy at one of the large medical centers nearby and are discharged while the pump is still running. The surgeon’s clinic may be a short drive away, yet getting there with a pump, a fresh incision and a walk-up apartment is a real effort. Follow-up visits at home cut down on those trips, and the treating clinician’s notes can go to the surgical team between appointments. Older buildings raise small questions too: is there an outlet near the bed for overnight charging, and is the elevator working on dressing change days?

Almost every kind of housing is found in the City of St. Louis: single-family brick homes, two-family and four-family flats, downtown lofts, high-rise apartments, senior housing towers and large older homes divided into units. It also has many skilled nursing facilities, assisted living residences and rehabilitation centers. Gateway arranges partner clinician visits in all of these. For a high-rise, we ask about the front desk and where to park. For a flat, we ask which bell to ring. We collect those details so the treating clinician can focus on the patient.

When care happens at home

At home, three parties usually share the work. A home health nurse changes the dressing on set days each week. A medical equipment supplier ships the pump, canisters and dressing kits. The treating clinician visits to examine the wound and update the orders.

Gateway schedules that clinician visit and, where possible, lines it up with a dressing change day so the wound is seen uncovered without an extra change. We also send the clinician’s notes and new orders to the home health agency, so the nurse who arrives next is working from the current plan.

For residents of nursing and senior living communities

Rehabilitation adds movement to the picture. A resident on negative pressure therapy still goes to the therapy gym, transfers in and out of a wheelchair and practices stairs, all with a pump and tubing attached. The treating clinician and facility nurses work out where the tubing runs so it is not sat on or pulled, and therapists learn what an alarm means and whom to tell.

Discharge planning should start early in a rehabilitation stay. Before the resident leaves, the plan should settle which agency will change the dressing at home, whether the facility’s pump stays behind and a home unit must be ordered, and when the wound will next be seen.

Changes to report

When you call about a wound VAC, a few details help the nurse or treating clinician act quickly: what the pump screen says, when the dressing was last changed and what the canister holds. Call promptly for:

• A canister that has filled since the last check
• Drainage that changes from pale or pink to dark, bloody or cloudy
• A dressing that has come loose and cannot be sealed again
• A new bad smell from the wound area
• The person seeming more tired, feverish or unwell

If there is steady bleeding, bright red blood in the tubing, chest pain or trouble breathing, call 911 first and make other calls afterward.

How primary care fits in

Suction cannot make up for what the bloodstream does not deliver. High blood sugar slows repair and raises infection risk, and narrowed arteries in the legs can leave a foot wound short of the oxygen it needs. If a wound on negative pressure therapy is not shrinking, the treating clinician often wants to know how diabetes is being managed and whether circulation has been tested.

Primary care is where those threads are followed: glucose records, medication review, referrals for vascular studies. Arranging both kinds of care through one coordinator means the wound clinician’s question reaches someone who can act on it.

Primary care at home in the City of St. Louis →

Getting care arranged in the City of St. Louis

Clinicians and facility staff referring a patient for wound VAC follow-up in the City of St. Louis can call 314-325-0126 or fax 314-786-7966. Helpful to include: demographics and insurance, the working diagnosis, recent wound notes and measurements, current orders, the medication list and relevant test results. Please also tell us who should receive the treating clinician’s notes afterward. The online referral form takes contact details only, so clinical records should come by fax, not through the form. Gateway confirms that the referral arrived, checks availability for the patient’s address and lets your office know what has been scheduled.

An address that says St. Louis can be in the city or the county, so give the ZIP code and neighborhood when you call. Have a reliable phone number, the name of the patient’s doctor or health center, and any discharge papers. Gateway arranges care throughout the City of St. Louis, including Downtown, the Central West End, North St. Louis and South St. Louis, and in Clayton and Central County next door. Building access and parking affect visits here more than distance does, so tell us about entry doors, buzzers and elevators.

• County: City of St. Louis, Missouri (an independent city)
• ZIP codes: 63101, 63103, 63104, 63106, 63108, 63109, 63110, 63111, 63112, 63113, 63115, 63116, 63118, 63139, 63147
• Nearby hospitals: Barnes-Jewish Hospital; SSM Health Saint Louis University Hospital (not affiliated with Gateway)
• Nearby communities: Downtown St. Louis, Central West End, North St. Louis, South St. Louis, Clayton and Central County
• Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

More wound care in the City of St. Louis

Read the full guide to wound VAC therapy, or see everything Gateway arranges on the mobile wound care in the City of St. Louis page.

• Diabetic foot ulcers
• Venous leg ulcers
• Pressure injuries and bed sores
• 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 and NPWT follow-up in Downtown St. Louis
• Wound VAC and NPWT follow-up in the Central West End
• Wound VAC and NPWT follow-up in North St. Louis
• Wound VAC and NPWT follow-up in South St. Louis

Common questions