About 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

A care plan for a stalled wound usually has several parts working together, because one change alone is seldom enough. The treating clinician may decide on some combination of:

  • Clearing unhealthy tissue so the wound bed can rebuild
  • A dressing matched to how much the wound drains
  • Taking weight or friction off the area
  • Controlling swelling in the limb
  • Referral to a vascular, surgical, dermatology or infectious disease specialist

Each part is assigned to someone: the clinician, a nurse, a caregiver or the patient. The plan also sets a point at which progress will be judged and the approach reconsidered if the wound has not responded.

Arranging this care in St. Peters

In many households in St. Peters, the person helping with wound care leaves early for work and gets home late. A dressing plan that needs midday attention will not hold up. Tell us the real schedule, and the treating clinician can consider dressings with longer wear times, home health nursing or a different routine. We can set up visits so a family member joins by phone, and we send a plain summary afterward. Newer senior living communities in the area can be visited too, and we ask their staff what they are able to assist with.

Interstate 70 carries most of the traffic through St. Peters, a St. Charles County city set between St. Charles to the east and O’Fallon to the west. Mid Rivers Mall Drive is the main north-south route, lined with shopping centers, and subdivisions fill in the blocks behind it. It is a car-dependent place. When a wound, weakness or a recent surgery makes getting in and out of a car hard, even a short drive to an appointment becomes a project. Care that comes to the home or facility takes the car out of the picture.

At home between visits

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.

Signs to tell the clinician about

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.

Primary care and overall health

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 St. Peters →

How to get started in St. Peters

Before anything is scheduled, Gateway checks two things for every request for non-healing wound care in St. Peters: whether a partner clinician serves that address and care setting, and what the patient’s plan requires from the treating provider. Neither is assumed. If both line up, we arrange the visit and gather records. If something stands in the way, we say so, and our guide to following up on a request explains what to ask next. Gateway coordinates the care and does not make clinical decisions. Those belong to the treating clinician who sees the wound. Start by calling 314-325-0126, or ask a family member to call for you.

Barnes-Jewish St. Peters Hospital sits within the city, and many residents also receive care at SSM Health St. Joseph Hospital in St. Charles or Progress West Hospital in O’Fallon. Gateway is not affiliated with any of them. If you or a relative is coming home from one of these hospitals with a wound or a new care need, you can call us before or after discharge. Discharge planners and case managers can refer by phone or fax, and we coordinate records, the clinician’s orders and the first visit with a partner clinician.

  • County: St. Charles County, Missouri
  • ZIP codes: 63376
  • Nearby hospitals: Barnes-Jewish St. Peters Hospital; SSM Health St. Joseph Hospital in St. Charles; Progress West Hospital in O'Fallon (not affiliated with Gateway)
  • Nearby communities: St. Charles, O'Fallon, Missouri, Cottleville, Weldon Spring, St. Charles County
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Other conditions and nearby communities

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

Common questions

Is there someone in St. Peters 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 St. Peters, 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.

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.

Will the clinician need to remove tissue from the wound, and does it hurt?

Removing dead or unhealthy tissue, called debridement, is common in chronic wound care because that tissue blocks repair and shelters bacteria. Whether it is needed, and by which method, is the treating clinician’s decision. Some methods are gentle and gradual. Others are done with instruments, with attention to comfort. Tell the clinician about your pain beforehand and ask what to expect.

Do I have to cross the Missouri River to get wound care if I live in St. Peters?

No. Gateway arranges wound care visits with partner clinicians in St. Peters itself, at your home or at the facility where you live. If the treating clinician orders a test or a specialist visit that has to happen elsewhere, we help coordinate that too, including transportation arrangements. The aim is to keep routine wound follow-up close to home.

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.