Venous leg ulcer care in the Riverbend.

Understanding venous leg ulcers

Healing rarely moves in a straight line with a venous leg ulcer. Early in care, drainage often changes before size does, and a leg that is less swollen is usually an encouraging sign. The wound may even look larger for a time as unhealthy tissue clears from its edges.

Progress can stall when swelling returns, when compression is off for long stretches, or when an infection or skin reaction sets in. Clinicians compare measurements from visit to visit and rethink the plan if the ulcer stops changing. After the skin closes, the vein problem is still there, so these ulcers are known for returning unless swelling stays controlled over the long term.

What the treating clinician looks at

Before anything is wrapped, the treating clinician needs to know that the arteries in the leg can tolerate pressure. That usually means feeling for pulses in the foot, and often a bedside test that compares blood pressure at the ankle with blood pressure in the arm. If the result is unclear, further vascular testing may be ordered.

This step matters because some leg ulcers involve both vein and artery disease, and those call for a different plan. Once circulation is understood, the clinician decides whether compression is appropriate, which form to use and how firm it should be. The dressing choice follows, matched mainly to how much the ulcer drains.

Arranging this care in the Riverbend

On the Illinois side of the river, venous ulcer care involves a different set of health plans and hospitals. If you live in the Riverbend, your coverage may be Illinois Medicaid, a Medicare Advantage plan offered in Illinois, or an employer plan, and each has its own rules for visits, compression garments and dressings. Gateway confirms the treating provider and your plan details before the first visit, so you know where things stand. We cannot say in advance what a plan will pay. Benefits depend on the treating provider, the plan and the care needed.

Each town in the Riverbend has its own housing. Wood River, Roxana, East Alton and Hartford have many compact one-story houses on a street grid, Bethalto and Godfrey have ranch homes and newer subdivisions with more land, and Alton has older houses on hills. Senior apartments, assisted living, and skilled nursing and rehabilitation centers are spread among the towns. Gateway arranges partner clinician visits in homes and facilities throughout the area, and when a patient moves from one town or setting to another, we carry the records, orders and schedule along.

When care happens at home

Most of the healing in a venous leg ulcer happens between visits. The treating clinician leaves instructions for those days: how long a wrap stays on, how to keep it dry, when to put your feet up, and what to do if a wrap slides down. If a wrap comes off early or drainage soaks through, call instead of waiting for the next scheduled visit. Gateway takes those calls, relays the question to the clinician and arranges whatever follows, such as a supply shipment or an earlier visit when one is available. Writing down questions as they come up makes each visit more useful.

In a facility

In a skilled nursing facility, venous leg ulcer care is shared work. The partner clinician sees the resident on site, assesses the ulcer and the circulation, and writes or recommends orders in line with the facility’s process. Nursing staff carry out dressing changes and compression between visits and document what they see. Gateway keeps the two connected by scheduling rounds with the facility, sending visit notes and following up on open questions. The attending physician stays informed and remains in charge of the resident’s overall medical care, including the heart, kidney and medication issues that affect leg swelling.

Signs to tell the clinician about

Compression should feel snug and supportive, not painful. Contact the treating clinician promptly if any of these occur while a wrap or garment is on:

• Toes that look pale, bluish or darker than usual, or feel cold
• Numbness, tingling or pins and needles in the foot
• New or sharper pain under the wrap, particularly over the shin or ankle
• A wrap that has rolled, slid down or formed a tight band
• Swelling that bulges above or below the wrap

Follow the instructions you were given for these situations, including whether to take the wrap off. Call 911 if the foot or leg suddenly turns cold, pale and severely painful.

How primary care fits in

The calf muscle acts as a pump for the leg veins, and it only works when the ankle moves. Arthritis, nerve damage, an old injury, pain from the ulcer itself or fear of falling can shrink a person’s walking to a few steps a day. A primary care clinician can look at what is limiting movement, manage pain, review fall risk and order physical therapy or equipment when appropriate. Sleep is part of this too. People who sleep upright in a recliner because of breathing trouble or back pain keep their legs down all night, and the reason behind that habit needs a medical answer.

Primary care at home in the Riverbend →

Getting care arranged in the Riverbend

If you have been managing a wound mostly on your own and are looking for venous leg ulcer care in the Riverbend, you can call Gateway yourself at 314-325-0126. Tell us what the wound looks like now, what the last clinician said about it and what is getting harder to manage. It helps to know the patient’s insurance and the names of the doctors involved, but do not wait until you have everything. We check whether a partner clinician can see the patient at home or in their facility, and we tell you what we find. The treating clinician takes it from there, and you stay part of the conversation.

The two general hospitals in the Riverbend, Alton Memorial Hospital and OSF Saint Anthony’s Health Center, are both in Alton. Patients from Wood River, Bethalto and the other towns are commonly discharged from them, and Gateway has no affiliation with either. A discharge to a home a few towns away can leave a family unsure who checks the wound next. Families can call us with that question. Discharge planners can refer by phone at 314-325-0126 or fax at 314-786-7966, and we coordinate follow-up with a partner clinician and the regular doctor.

• County: Madison County, Illinois
• ZIP codes: 62002, 62035, 62024, 62095, 62010
• Nearby hospitals: Alton Memorial Hospital; OSF Saint Anthony's Health Center in Alton (not affiliated with Gateway)
• Nearby communities: Alton, Godfrey, Illinois, Edwardsville, Granite City
• Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Other conditions and nearby communities

Read the full guide to venous leg ulcers, or see everything Gateway arranges on the mobile wound care in the Riverbend page.

• Diabetic foot 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
• Venous leg ulcer care in Alton
• Venous leg ulcer care in Godfrey
• Venous leg ulcer care in Edwardsville
• Venous leg ulcer care in Granite City

Common questions