Gateway nurse practitioners initiate, manage, and troubleshoot negative pressure wound therapy (wound vac) in your home or care facility — no hospital admission, no SNF stay required.
Negative pressure wound therapy (NPWT) — commonly called wound vac therapy — uses a sealed foam or gauze dressing connected to a portable pump to apply continuous or intermittent subatmospheric (negative) pressure to a wound. That gentle suction pulls excess wound fluid (exudate) away from the wound bed, reduces edema in surrounding tissue, brings blood flow closer to the wound surface, and mechanically stimulates the formation of granulation tissue — the healthy pink tissue that is the foundation of wound healing.
NPWT has strong evidence behind it for complex wounds. It has been used in hospital and SNF settings for decades, but advances in portable, quieter devices have made home NPWT both clinically effective and practically manageable for patients and caregivers. Gateway Wound Care manages the full NPWT service in your home or facility throughout Greater St. Louis — from Chesterfield to Creve Coeur to Des Peres and beyond.
NPWT is indicated for wounds that are too large, too deep, or too complex to heal with standard dressings alone — or that are not showing adequate progress after appropriate conservative wound management. Common indications include:
Not every wound is appropriate for NPWT. Contraindications include untreated osteomyelitis, necrotic tissue with eschar (debridement is required first), exposed arteries or veins, and bleeding wounds. Your Gateway NP will assess your wound thoroughly before recommending or initiating wound vac therapy.
Gateway provides end-to-end NPWT management — from the initial clinical decision to initiate therapy through device setup, ongoing dressing changes, and therapy discontinuation. We coordinate with your DME supplier for device delivery and technical support, so you are never navigating two separate care teams without a point of contact.
Your Gateway NP assesses the wound, determines NPWT candidacy, orders the device through a Medicare-contracted DME supplier, and applies the initial dressing at your home. Pressure settings, dressing type (foam or gauze), and therapy mode (continuous or intermittent) are selected based on wound characteristics.
Most NPWT dressings require changing every 2–3 days; canisters may fill more quickly for high-exudate wounds. Your NP visits on the prescribed schedule to change the dressing, assess wound progress, and document healing trajectory. A photo is taken at each visit and shared with your physician.
We educate patients and caregivers on device operation, common alarm causes, bathing precautions, and when to call us. When the wound is ready, we transition off NPWT to standard dressings — or coordinate with your surgeon for grafting or surgical closure.
Patients sleep better, eat better, and experience less anxiety in their own home. Modern portable NPWT devices are quiet enough to allow normal sleep and daily activity — there is no clinical reason to be in a hospital for wound vac therapy alone.
Hospital and SNF care involves rotating nursing staff. Home NPWT with Gateway means the same NP sees the same wound at every visit — tracking subtle changes in granulation tissue, periwound health, and exudate character that can signal infection or stalled healing.
Hospitalization or SNF placement solely for wound vac management generates significant facility costs — room and board, ancillary services, facility fees — that do not apply to home care. For most patients with adequate caregiver support, home NPWT is the more cost-effective pathway.
Immunocompromised patients with chronic wounds are particularly vulnerable to hospital-acquired infections. Home care eliminates exposure to multi-drug-resistant organisms common in institutional settings.
Medicare covers NPWT devices for use in the home under the Durable Medical Equipment (DME) benefit, subject to the Medicare Local Coverage Determination (LCD) for NPWT. Coverage requires documentation of wound type (qualifying diagnoses include chronic wounds, surgical wounds, and traumatic wounds meeting specific criteria), wound dimensions, and evidence that standard wound care has not produced adequate healing. Gateway NPs provide complete documentation at every visit to support coverage.
The NPWT device is billed through a Medicare-contracted DME supplier; Gateway's clinical NP visits for wound assessment and dressing changes are billed separately under Medicare Part B. Most major commercial insurance and Medicare Advantage plans also cover home NPWT with appropriate documentation. We verify your benefits before starting therapy.
We provide wound vac therapy management throughout Greater St. Louis — including in Chesterfield, Creve Coeur, Town & Country, Kirkwood, Ballwin, and throughout our 50-mile service area.