Surgical incisions
After surgery, a nurse checks the incision, changes the dressing as ordered and looks for early signs of infection or opening.
Wound care at home
Wound care at home, step by step.
A home health nurse can care for a surgical incision, a pressure sore, a diabetic wound or another slow-healing wound in your home, including a wound VAC. Here is what to expect, what to watch for and how your family can help between visits.
Wounds treated at home
What types of wounds can be treated at home?
Many wounds can be cared for at home, including surgical incisions, pressure injuries and diabetic or other slow-healing wounds. A home health nurse checks the wound, changes the dressing your doctor ordered and teaches you what to watch for. Wound care is skilled nursing care, which Medicare covers at home if you qualify. See who qualifies
Pressure injuries
Also called pressure sores or bedsores. A nurse cares for the wound and shows your family how to take pressure off the skin.
Diabetic and slow-healing wounds
Foot sores from diabetes and other wounds that heal slowly need regular checks, the right dressing and steady blood sugar.
Wound VAC at home
What is a wound VAC, and what should families know?
A wound VAC is a small machine that gently pulls fluid away from a wound through a sealed foam dressing and a tube. Its medical name is negative pressure wound therapy. Doctors order it for some surgical, pressure and diabetic wounds.
BREMA nurses provide negative pressure wound therapy at home, including wound VAC dressing changes and device checks, as ordered by the physician. Your doctor’s orders set how often the dressing is changed.
Living with a wound VAC
- Keep the machine on unless your nurse or doctor tells you otherwise.
- Keep the tubing free of kinks, and don’t let it get pulled or pinched.
- Keep the battery charged and the charger close by.
- An alarm often means a leak, a full canister or a low battery. Follow the steps your nurse showed you, and call if it won’t stop.
- Keep the dressing dry. Ask your nurse how to bathe safely.
- Keep the equipment supplier’s phone number next to the machine.
If you see a lot of bright red blood in the dressing, tubing or canister, call 911.
Home health wound care
How do dressing changes work at home?
At each visit, a nurse checks the wound, cleans it and puts on the dressing your doctor ordered. How often the nurse comes depends on the wound and your doctor’s orders.
Check the wound.
The nurse looks at the wound and the skin around it and measures it, so changes are easy to spot.
Clean and redress.
The nurse cleans the wound and puts on the dressing your doctor ordered.
Teach your family.
If your plan includes it, the nurse shows you or a caregiver how to help and what to watch for.
Update your doctor.
The nurse shares how the wound is doing with the ordering doctor or wound clinic.
Warning signs
How do I know if a wound is infected or not healing?
Call your doctor or home health nurse if the wound looks worse, smells bad, drains more, hurts more or you have a fever. A wound that isn’t getting better over the time your nurse said to expect needs a call too.
Call your doctor or home health nurse
- Redness or warmth that spreads around the wound
- More swelling or pain than before
- Pus, cloudy drainage or a bad smell
- Fever or chills
- The wound gets bigger or deeper, or its edges open
- A wound VAC alarm that won’t stop
Call 911
- Heavy bleeding that won’t stop, including in wound VAC tubing
- Chest pain or trouble breathing
- Fainting, or sudden confusion
BREMA’s office is open Monday–Friday, 8 a.m.–5 p.m., at 214-339-9466.
Food and healing
What should someone eat to help a wound heal?
The body needs enough protein, fluids and calories to heal a wound. For people with diabetes, keeping blood sugar in the range the doctor set also helps. Ask the doctor before changing a diet that is already prescribed, such as a low-salt or fluid-limited diet.
Simple ways to help
- Add some protein to each meal, such as eggs, beans, fish, chicken or yogurt.
- Drink enough fluids, unless the doctor has limited them.
- Offer small meals or snacks if appetite is low.
- Check blood sugar as the doctor ordered.
- Ask the doctor before starting vitamins or supplements.
Supplies and cost
Does Medicare cover wound care supplies at home?
Yes. Under Original Medicare, the supplies used in your home health care are included, and you pay $0 for covered home health visits. A wound VAC may have a separate cost. Other plans vary, and we explain any costs before your first visit.
Nursing visits
$0 under Original Medicare for covered home health visits, when you qualify.
Wound supplies
Under Original Medicare, the supplies used in your home health care are included.
Wound VAC equipment
May be billed separately. When a wound VAC is rented as medical equipment under Original Medicare, it usually costs 20% after the Part B deductible.
Medicare Advantage and other plans vary. See who qualifies for home health. Source: Medicare.gov, Home health services (opens in a new tab)
Between visits
What can families do between wound care visits?
Families help most by keeping the dressing clean and in place, protecting the skin from pressure and watching for warning signs. Your nurse can show you which of these fit your loved one’s plan.
- Wash your hands before and after you touch the dressing.
- Keep the dressing clean, dry and in place. Don’t change it unless your nurse taught you how.
- For a pressure injury, help your loved one change position as often as the nurse advises.
- Use the cushions or pillows the nurse suggests to keep weight off the wound.
- For a diabetic foot wound, keep shoes and socks on as advised, and avoid walking barefoot.
- Help with meals, fluids and medicines on schedule.
- Keep follow-up visits with the surgeon or wound clinic.
- Write down questions and any changes you notice for the next visit.
For referral partners
Can BREMA manage a wound VAC at home?
Yes. BREMA nurses provide negative pressure wound therapy at home, including wound VAC dressing changes and device checks, as ordered by the physician. Fax the packet and you’ll have a yes or no within 30 minutes, Monday–Friday, 8 a.m.–5 p.m.
What we provide
- Wound checks and measurements at each visit
- Dressing changes as ordered
- Wound VAC dressing changes and device checks
- Care for surgical, pressure and diabetic wounds
- Updates to the ordering physician or wound clinic
Send with the referral
Send the standard referral packet plus the wound care and wound VAC items on our complex and specialty care page.
A wound VAC and its supplies may be billed separately from the home health visits, depending on the device and the plan.
Does Medicare cover wound care at home?
Yes, if you qualify for home health. Wound care is skilled nursing care. You need a doctor’s order, a part-time skilled need and to be homebound. Under Original Medicare, you pay $0 for covered visits, and the supplies used in your care are included. See who qualifies.
Who changes a wound VAC dressing at home?
BREMA nurses provide wound VAC dressing changes and device checks at home, as ordered by the physician. Your doctor’s orders set how often the dressing is changed.
Can family members change a wound dressing?
Sometimes. If your plan includes it, the nurse can teach you or a caregiver how to change a simple dressing. Don’t change any dressing, including a wound VAC dressing, unless your nurse has shown you how.
How is a diabetic foot wound cared for at home?
A nurse checks the wound, changes the dressing as ordered and helps you keep pressure off the foot. Steady blood sugar, good food and daily foot checks also help. Call if you see redness, swelling, drainage or a bad smell.
How do you care for a pressure sore at home?
The nurse cleans and dresses the sore as ordered and shows your family how to take pressure off the skin, such as by changing position and using cushions. Good food and fluids help too.
Do I need a hospital stay to get wound care at home?
No. Medicare does not require a hospital stay before home health. If you qualify and your doctor orders it, wound care can start from home.
Can I choose BREMA for wound care?
Yes. You can choose any Medicare-certified home health agency that serves your area. Tell your doctor, hospital or nursing facility you want BREMA.
Questions about a wound?
Call us Monday–Friday, 8 a.m.–5 p.m. We can tell you if home health may help, whether we serve your address and if we take your plan. You choose your home health agency.
Source: Medicare.gov, Home health services (opens in a new tab)