What advanced wound care means
Advanced wound care in St. Louis is not a single treatment. It is a closer level of attention for wounds that are complex, slow to improve or at risk of serious problems. It starts with a full assessment and a search for what is holding the wound back.
Basic care keeps a wound clean, covered and protected. Advanced care adds regular measurement and documentation, a review of your health conditions, and treatment options beyond a standard dressing when they fit the wound.
Gateway does not provide the clinical care itself. We connect you with partner clinicians and coordinate the work around each visit. The treating clinician makes every clinical decision.
Who advanced wound care may help
- A wound that has not made steady progress after several weeks of care
- A diabetic foot ulcer, especially with numbness or reduced blood flow
- A leg ulcer linked to vein problems, artery problems or both
- A pressure injury that is deep or keeps getting worse
- A surgical wound that has opened or is draining
- A wound with tunneling, heavy drainage or exposed deeper tissue
What the treating clinician may do
The first visit is mostly assessment. The clinician looks at the wound’s size, depth, tissue, drainage and surrounding skin, and asks what has been tried so far. They may also check pulses, sensation, swelling and pressure points.
The plan may then include:
- Debridement, which is the removal of dead or unhealthy tissue
- Dressings matched to the wound’s depth and drainage
- Compression for leg swelling, once circulation has been considered
- Offloading, which means taking pressure off a foot wound
- Negative pressure wound therapy, often called a wound VAC
- Skin substitutes for certain wounds that meet clinical and plan criteria
- Orders for lab work, imaging or a circulation study
Often the most useful step is a simple plan that everyone follows the same way.
Looking for the reason a wound is stuck
A wound rarely stalls for one reason. Blood flow, pressure, swelling, infection, blood sugar, nutrition and some medications can each slow healing.
When the clinician suspects a deeper cause, they may order tests or recommend a specialist, such as a vascular or podiatry practice. Gateway helps set up those appointments and get the results back to the treating clinician.
How Gateway arranges advanced wound care at home
You, a family member or a caregiver can call us directly. We take your contact details, confirm your location and care setting, and check visit availability for your location.
Before the visit, we gather records such as discharge papers, current wound orders and a medication list. Afterward, we follow up on supply orders and the next appointment. Home visits are arranged through mobile wound care across Greater St. Louis and the Metro East.
Advanced wound care in nursing and assisted living facilities
Partner clinicians also see residents in skilled nursing facilities, assisted living, memory care and rehabilitation centers. Gateway coordinates visit days with the nursing staff so the right residents, records and supplies are ready.
After each visit, the clinician’s orders and notes go to the facility team, who carry out daily care between visits. Facility staff can read more about mobile wound care for skilled nursing and assisted living.
Working with primary care and your other clinicians
Your primary care clinician manages conditions that affect healing, such as diabetes, heart disease and kidney disease. Wound care adds to that care and does not replace it.
Gateway helps make sure visit findings and order changes reach your primary care office, your home health nurse and any specialists involved. If you do not have a primary care clinician, ask us about primary care and wound care together.
Changes to report between visits
Call the treating clinician if you notice:
- Redness, warmth or swelling that is spreading
- New or worse pain
- More drainage, thicker drainage or a new odor
- Fever or chills
- A wound that looks larger, darker or deeper
Gateway is not an emergency service. Call 911 for a foot or leg that suddenly turns cold, pale or blue, bleeding that will not stop, chest pain, trouble breathing, sudden confusion or fainting.
How to start
Call 314-325-0126, or request care and we will call you back. The form asks only for your name and phone number, so please save medical details for the call. You do not need a referral.
Hospitals, facilities and practices can refer a patient online or by fax at 314-786-7966.
Common questions
Is advanced wound care the same as going to a wound clinic?
It can involve the same kinds of assessment and treatment, but the setting differs. A wound clinic sees you at an outpatient center. Partner clinicians who work with Gateway may see you at home or in your facility. If the clinician decides part of your care is safer in an office or outpatient setting, they will tell you.
Does every slow wound need an advanced treatment?
No. Many wounds improve once the cause is addressed, such as pressure, swelling or a dressing that does not match the drainage. Skin substitutes and wound VAC therapy are considered only for certain wounds, usually after standard care has been tried and documented. The treating clinician decides what is appropriate for your wound.
Will my insurance pay for advanced wound care?
It depends on your plan, the treating provider and the care that is ordered. You can ask us about Medicare, Medicare Advantage, Medicaid and commercial plans when you call. Some treatments need prior authorization or specific documentation first. We can explain what to ask your plan, but we cannot tell you what will be covered.
How often will the clinician see my wound?
The treating clinician sets the schedule based on the wound and the treatment plan. Some wounds are seen more often early on, then less often as they improve. Between visits, daily care is usually done by you, a caregiver, a home health nurse or facility staff, following the clinician’s orders.
Related pages
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.