A nurse practitioner comes to your home or facility to treat your venous leg ulcer with multi-layer compression therapy, debridement, and advanced wound dressings. Consistent, evidence-based care without the clinic trip.
A venous leg ulcer (VLU) is a chronic wound caused by venous hypertension — the sustained back-pressure that develops when vein valves in the legs fail. The ulcer most often appears on the medial aspect of the lower leg, above the ankle, in an area called the gaiter zone. VLUs account for roughly 70–80% of all leg ulcers and disproportionately affect older adults.
Left untreated, a venous ulcer can persist for months or years, enlarge, become infected, and seriously limit mobility and quality of life. The clinical fundamentals of VLU healing are well established: graduated compression, wound bed preparation, infection control, and exudate management. Getting these fundamentals right, every visit, is what leads to closure — and that is what Gateway Wound Care delivers in the home.
Our nurse practitioners travel directly to St. Louis-area patients in Chesterfield, Creve Coeur, Kirkwood, Ballwin, and throughout the 50-mile Gateway service area — so patients never have to arrange transportation for ongoing wound care.
Venous leg ulcers develop when chronic venous insufficiency leads to swelling, skin changes, and tissue breakdown. Recognizing the early signs — before a full ulcer forms — is one of the most important steps in preventing a long, difficult healing course.
Gateway Wound Care follows the evidence-based VLU treatment framework: confirm the diagnosis, rule out arterial disease, prepare the wound bed, apply graduated compression, and reassess at every visit. Every nurse practitioner visit is documented with measurements and photos, with updates sent to the referring or primary care physician.
Before compression is applied, we assess for coexisting peripheral arterial disease. When clinically indicated, we coordinate ABI (ankle-brachial index) testing and refer to vascular surgery before proceeding with full compression.
We remove slough and devitalized tissue using conservative sharp and enzymatic debridement at home, and select advanced dressings matched to wound depth and exudate.
Multi-layer compression bandaging (typically 30–40 mmHg at the ankle) is applied each visit, re-assessed for fit and tolerance, and transitioned to compression hosiery once the ulcer closes to prevent recurrence.
We confirm Medicare or commercial insurance coverage before the first visit — no surprise billing. Care coordinators handle physician orders and faxed referrals at (314) 689-1318.
Your nurse practitioner arrives on schedule, performs a full wound assessment, checks pulses, screens for arterial disease, and begins treatment on that first visit whenever safe to do so.
Most venous ulcers need dressings and compression changes one to two times per week. We adjust frequency based on drainage, tolerance, and progress toward closure.
When a wound stalls or we detect arterial compromise, we coordinate directly with vascular surgery. Gateway is your home wound care partner — not a substitute for needed specialist care.
Gateway Wound Care treats venous leg ulcer patients throughout the St. Louis metro — in private homes, assisted living facilities, and skilled nursing communities. Our nurse practitioners cover a 50-mile service area with typical response times of 24–48 hours from referral.