About diabetic foot ulcers
A diabetic foot ulcer is an open wound on the foot of a person with diabetes, deep enough that the full thickness of the skin is gone. Common places are the ball of the foot, the tips and tops of the toes, the heel and the outer edge of the foot. It can look like a shallow crater ringed with thick callus, or like a small hole that runs deeper than its opening suggests. Clinicians describe an ulcer by its location, size and depth, the tissue in its base, and whether infection or poor blood flow is present. Those descriptions guide what gets ordered, and they give everyone involved a shared way to tell whether the wound is improving.
What an assessment covers
A care plan for a diabetic foot ulcer usually rests on a few parts that the treating clinician fits to the person. Pressure relief comes first, whether through a removable boot, a cast, a special shoe or limits on standing. Next is preparing the wound bed, which may mean removing callus and dead tissue during visits. A dressing is chosen to match the amount of drainage, and it may change as the wound does. Infection, if present, is addressed with the testing and treatment the clinician orders. Finally, the plan names who changes the dressings, how often visits happen, and what finding at follow-up would prompt a different approach.
Diabetic foot ulcer care in Affton
In Affton, a person with a foot ulcer is often a long-time homeowner whose spouse or neighbor helps out, and whose podiatrist and primary care doctor are close by. That existing circle is an asset. Gateway sends updates to each office after wound visits, so the people who know the patient are not working from old information. Seniors who have moved to an independent or assisted living community nearby can be seen there too. In either setting, show the clinician the worn house shoes by the door, because comfortable old footwear is a frequent source of rubbing.
Affton sits just southwest of the St. Louis city limits, an unincorporated South County community that grew up along Gravois Road and Mackenzie Road. Blocks of brick bungalows and modest ranch houses fill the streets between them, and many households have been in the same home for decades. That staying power is the reason care at home matters here. When a wound needs regular attention or a chronic condition needs follow-up, a visit to the house or to a nearby facility spares an older adult the drive, the parking lot and the waiting room.
Care at home
Family caregivers do much of the day-to-day work when a diabetic foot ulcer is cared for at home. A spouse or adult child may be the only person who can see the sole of the foot, hold a mirror or notice a damp sock. The treating clinician decides which dressing tasks a caregiver can take on and explains what is expected. Caregivers also help by keeping the offloading device within reach, clearing clutter from walking paths, and writing down blood sugar readings and questions for the next visit. If the tasks become more than your household can manage, tell us and we will raise it with the clinician.
In a facility
Assisted living poses a particular challenge for diabetic foot ulcers. Residents are fairly independent, staff may not be permitted to change wound dressings, and a person can walk on a sore foot for days before anyone sees it. When Gateway arranges visits in an assisted living community, we ask who handles dressings between visits: facility staff, a home health nurse or family. The treating clinician shapes the plan around that answer. We also let the community’s nurse or wellness director know what to watch for, such as drainage on socks or a resident who has stopped wearing the prescribed shoe.
Signs to tell the clinician about
A foot ulcer can affect the whole body, and sometimes the first warning shows up away from the wound. Tell the treating clinician about:
- Blood sugar readings that run higher than usual for no obvious reason
- Nausea, poor appetite or unusual tiredness
- New pain in a foot that normally feels very little
- A sore, crack or callus appearing on the other foot
- A fall, or an offloading device that is damaged or no longer fits
Call 911 for severe shortness of breath, chest pain, new confusion or a person who cannot be woken.
How primary care fits in
Blood sugar and wound healing are closely tied. When glucose runs high over time, the cells that fight infection and rebuild tissue work less well, and an infected wound can in turn push readings higher. Wound visits do not manage diabetes medications. That belongs to the primary care clinician or endocrinologist, who may review recent readings, lab results and the current regimen while the ulcer is being cared for. Gateway helps the two sides share information, so the clinician managing diabetes knows there is an open wound and the wound clinician knows how glucose has been running.
Arranging diabetic foot ulcer care in Affton
To arrange diabetic foot ulcer care in Affton, call Gateway at 314-325-0126. Patients, family members and caregivers can call directly, and a referral is not required. We will ask where the patient lives, what has been done for the wound so far and which clinicians are involved. Gateway then confirms whether a partner clinician is available for that address and care setting, requests the relevant records and schedules the visit. At that visit the treating clinician examines the wound and decides on the plan. Our job from then on is the coordination: orders, supplies, follow-up visits and keeping the care team informed.
People in Affton are most often hospitalized at Mercy Hospital South, SSM Health St. Mary’s Hospital in Richmond Heights or St. Luke’s Des Peres Hospital. Gateway is not affiliated with any of them, but follow-up after a stay at any of the three can be arranged through us. A family member can call once a going-home date is known, and a discharge planner or case manager can send a referral by fax. We gather the discharge summary and wound orders, confirm the address in 63123, and arrange a visit with a treating clinician who directs wound care from there.
- County: St. Louis County, Missouri
- ZIP codes: 63123
- Nearby hospitals: Mercy Hospital South; SSM Health St. Mary's Hospital in Richmond Heights; St. Luke's Des Peres Hospital (not affiliated with Gateway)
- Nearby communities: Mehlville, South County, Webster Groves, Crestwood, South St. Louis, Shrewsbury
- Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation
Related care in Affton
Read the full guide to diabetic foot ulcers, or see everything Gateway arranges on the mobile wound care in Affton page.
- Venous leg ulcers
- Pressure injuries and bed sores
- Arterial and mixed wounds
- Non-healing wounds
- Post-surgical wounds
- Reopened (dehisced) surgical wounds
- Surgical site infections
- Skin tears and traumatic wounds
- Wounds with lymphedema
- Skin graft aftercare
- Wound VAC (NPWT) follow-up
- Diabetic foot ulcer care in Mehlville
- Diabetic foot ulcer care in South County
- Diabetic foot ulcer care in Webster Groves
- Diabetic foot ulcer care in South St. Louis
Common questions
How do I start diabetic foot ulcer care in Affton?
Call 314-325-0126 or send the request form with your name and phone number. Please leave medical details out of the form. We will call back to ask where you live, who is involved in your care and what has been tried so far. Then we confirm which partner clinician can see you and set up the first visit.
What should I have ready for the first visit?
Gather a current medication list, recent blood sugar readings if you keep them, and any hospital or clinic papers about the foot. Set out the shoes, inserts, boot or other devices you use, along with the dressing supplies you have on hand. Write down the names of your doctors and your questions. A chair with good light and a place to prop the foot make the exam easier.
Does a diabetic foot ulcer always mean there is an infection?
No. Every open wound has bacteria on its surface, and that is different from infection in the tissue. When clinicians suspect infection, they may order a culture, blood work or imaging to find out how deep it goes. Antibiotics are prescribed only when the clinician judges they are needed. Report changes quickly all the same, because infection in a diabetic foot can spread fast.
Is Affton part of the area Gateway serves, or does Gateway only work in St. Louis City?
Affton is part of the area. Gateway arranges care across Greater St. Louis, including unincorporated South County communities like Affton and the surrounding 63123 ZIP code. Because Affton has no city government of its own, mailing addresses usually read St. Louis, so give us the street address and ZIP when you call. Visit availability is confirmed for that location and care setting.
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.