What lymphedema wounds are

The lymphatic system carries extra fluid out of the tissues and back to the bloodstream. When its vessels are damaged, blocked or overloaded, protein-rich fluid builds up and the limb swells. That swelling is lymphedema. It can follow cancer surgery or radiation, repeated infections, long-standing vein disease or severe obesity, and some people are born with it.

Lymphedema wound care in St. Louis most often involves the lower legs. Over time the skin thickens and hardens, deep folds form, and small blisters may leak clear or straw-colored fluid. An open wound can start from a scratch, an insect bite, a burst blister or skin breakdown inside a fold. A related page covers leg swelling and weeping skin from other causes.

If you are looking for help with this wound close to home, start with our overview of wound care in St. Louis.

Why wounds on a swollen limb heal slowly

Swelling is the main obstacle. Stretched, fluid-filled tissue makes it harder for oxygen and nutrients to reach the wound edge. Other problems build on that:

  • Constant leaking keeps nearby skin wet, and wet skin softens and breaks down
  • Slow lymph flow clears bacteria poorly, so skin infection (cellulitis) is more likely, and each infection can damage lymph vessels further
  • Skin folds trap moisture and are hard to clean and dry
  • A heavy limb limits walking, and less movement means more swelling

A dressing alone seldom closes a lymphedema wound. Controlling the swelling is usually part of the plan.

What the treating clinician considers

The first question is what is causing the swelling, since several causes often overlap. The treating clinician then reviews:

  • Wound size, depth and how much it drains
  • Skin thickening, folds, blisters, rashes and cracks between the toes
  • Signs of cellulitis
  • Blood flow to the limb, often with circulation tests before compression
  • Heart and kidney conditions that affect how much compression is safe
  • Which wraps or garments have been tried, and what you can manage to put on
  • Whether a referral to a lymphedema therapist makes sense

The clinician decides whether compression is appropriate and in what form. Gateway coordinates the orders, supplies and scheduling for compression therapy and for lymphedema and edema management.

Lymphedema wound care at home and in facilities

Getting a large, heavy, leaking leg into a car and across a parking lot is hard work. Gateway arranges visits from partner clinicians in private homes, so the limb can be assessed where you live. Daily routines matter between visits: gentle washing and careful drying, moisturizing as directed, wearing wraps or garments as ordered, and raising the limb when resting. Many people cannot reach their own feet, so a family member or home health nurse often helps. Our guide on keeping compression wraps comfortable covers common problems.

In skilled nursing, assisted living and rehabilitation, the plan depends on staff applying wraps the same way on every shift. Legs that hang down in a wheelchair all day tend to swell more. The treating clinician works with nurses and therapists on a routine the facility can keep up.

How primary care factors in

A primary care clinician manages the conditions that add fluid to the legs, such as heart failure and kidney disease, and reviews medicines that can cause swelling. Water pills help some kinds of swelling and not others, so the cause matters.

If your lymphedema followed cancer treatment, your oncology team should hear about any new wound or infection. Gateway can help arrange primary care that looks at circulation and vascular health alongside wound visits.

Changes to report and when to call 911

Infection in a limb with lymphedema can move fast. Report these promptly:

  • New redness, warmth or tenderness, especially if it is spreading
  • Fever, chills or a flu-like feeling
  • A sudden increase in swelling
  • More leaking, new blisters or a bad smell
  • A wrap that causes numbness, tingling or pain, or toes that turn pale, blue or cold
  • Any new open area

Sudden, painful swelling in one leg needs urgent medical evaluation, because it can be a blood clot. Call 911 for chest pain, trouble breathing, coughing up blood, fainting, or confusion with a high fever.

How Gateway helps arrange care

You can call 314-325-0126 yourself or request a callback. Family members and caregivers can call too, and a referral is not required. The web form collects contact details only.

We gather records from the clinicians already involved, coordinate orders and supplies, and schedule the visit with a partner clinician. Availability is confirmed by location and care setting. Physician offices, therapists and facilities across Greater St. Louis and the Metro East can refer a patient as well.

Common questions

Why is my leg leaking clear fluid?

When a limb is very swollen, lymph fluid can seep through tiny breaks or blisters in the skin. The fluid irritates skin, and the open spots give bacteria a way in. Report leaking to a clinician, even if there is no obvious wound yet.

Can compression be used when there is an open wound?

Often it can, but the treating clinician makes that call after considering blood flow, heart function, pain and any active infection. Reducing swelling is usually central to healing these wounds. Do not wrap the limb tightly or pull on old stockings on your own. The wrong pressure in the wrong place can cause harm.

Will the lymphedema go away once the wound heals?

Usually not. Lymphedema is a long-term condition. The wound can close, but the swelling still needs daily management to lower the chance of new wounds and infections. Before wound visits end, ask what the long-term plan is, who will reorder garments and whom to call if the swelling increases.

Is every swollen leg lymphedema?

No. Legs swell for many reasons, including vein disease, heart failure, kidney or liver problems, certain medicines and blood clots. Several causes can be present at once, and long-standing swelling of any kind can strain the lymph system. Sorting out the cause is a job for your clinicians.

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.