What to know about wounds with lymphedema
Lymphedema is long-term swelling that builds when the lymphatic system cannot carry fluid out of an arm or leg as fast as it collects. The lymphatic system is a network of thin vessels and nodes that returns fluid to the bloodstream and helps the body fight infection. When it falls behind, fluid that is rich in protein settles in the tissue under the skin.
A lymphedema wound is any open area on a limb swollen this way. It may be a shallow raw patch, a blister that has burst, a split at the bottom of a skin fold or a deeper ulcer. Most are on the lower legs, ankles and feet. What they share is the setting: skin that is stretched, damp and slow to repair itself.
How the care plan is built
A first assessment usually starts with the story of the swelling. The treating clinician asks when it began, whether it affects one limb or both, and whether it goes down overnight. A history of cancer treatment, leg surgery, injuries, blood clots or repeated skin infections matters, and so does the list of current medicines.
This history points to the cause, or more often the mix of causes, and that shapes the care plan. Swelling driven mostly by the lymphatic system is handled differently from swelling driven by the heart, the kidneys or the veins. The clinician may want records or test results from other offices, and Gateway gathers those ahead of the visit when it can.
Local context: Belleville, Illinois
Crossing the river for a lymphedema therapy appointment can take a large part of a day from Belleville, with the leg down for the whole ride. Many people would rather have wound care come to them. Before a visit is scheduled, Gateway confirms two things: the treating provider who serves your address, and how that provider works with your coverage, whether that is Medicare, an Illinois Medicaid plan or a commercial plan. Participation and benefits depend on the provider, the plan and the care needed.
Near downtown Belleville, brick houses and duplexes are set close to the street. The west and east ends have ranch homes and subdivisions, and apartment complexes line the main routes. The city also has senior apartments, assisted living, memory care, and skilled nursing and rehabilitation centers, as you would expect in a county seat. Gateway arranges visits from partner clinicians in each setting. In homes we schedule with the patient or caregiver. In facilities we set visit days with the nursing staff and share the clinician’s orders after each visit.
When care happens at home
A home visit lets the treating clinician see the limb in the place where the swelling actually builds. The chair you spend the day in, the height of your bed and whether you have any way to prop up your legs all affect how much fluid collects. Those details are hard to describe in an office and easy to see in a living room.
It also spares you the trip. Moving a heavy, wrapped, draining leg into a car and through a waiting room is exhausting, and some people put off care because of it. Gateway arranges visits with partner clinicians in private homes, with availability confirmed by location.
For residents of nursing and senior living communities
Memory care and assisted living bring their own challenges for lymphedema. A resident with dementia may pull at a wrap, unroll it or be unable to say that it hurts, so staff need to know what to watch for: toes changing color, a wrap bunched behind the knee, fluid soaking through. The treating clinician takes this into account when choosing the type of compression.
Assisted living staff are often not permitted to change dressings or apply wraps. In that case the clinician may order home health nursing to come to the apartment, and Gateway coordinates among the agency, the community and the family.
Changes to report
Changes in the swelling itself can point to something beyond the wound. Tell the treating clinician about:
- Swelling that increases quickly over a day or two
- Swelling that moves higher, into the thigh, groin or belly
- Rapid weight gain, or shoes and garments that suddenly do not fit
- Needing extra pillows to breathe comfortably at night
Sudden swelling and pain in one leg, often with warmth in the calf, needs urgent medical evaluation because it may be a blood clot. Call 911 for chest pain, trouble breathing, coughing up blood, fainting, or a racing heartbeat with lightheadedness.
Primary care and overall health
Lymph flow in the legs gets much of its push from the calf and foot muscles squeezing with each step, so anything that limits walking tends to worsen swelling. Primary care can look at what is holding a person back, whether that is joint pain, breathlessness, weakness or fear of falling, and whether therapy would help.
General health affects the wound as well. Healing draws on protein and calories, high blood sugar slows repair and raises infection risk, and extra body weight adds pressure on lymph vessels in the groin and legs. These are long-term concerns that a primary care clinician follows alongside the wound visits.
How to get started in Belleville
For a resident of a nursing home, assisted living or memory care community in Belleville, a request for wound care with lymphedema can come from the family, the resident or the facility’s nurses. Call 314-325-0126 and give us the facility name, the unit or room and the best nurse contact. Gateway speaks with the facility about its process for outside clinicians, confirms availability and coordinates a visit time that fits the resident’s day. After the visit, the treating clinician’s orders are given to facility nursing, and the family contact on file gets an update if the resident has agreed to that.
Hospital care for Belleville is spread among Memorial Hospital Belleville, Memorial Hospital Shiloh and HSHS St. Elizabeth’s Hospital in O’Fallon, Illinois. Gateway is not affiliated with any of the three. A discharge often comes with wound instructions, medication changes and follow-up appointments that are hard to keep. Patients and family members can call us to ask about follow-up at home. Discharge planners and case managers at Metro East hospitals can refer by phone at 314-325-0126 or by fax at 314-786-7966. We request the records and coordinate a visit with a partner clinician.
- County: St. Clair County, Illinois
- ZIP codes: 62220, 62221, 62223, 62226
- Nearby hospitals: Memorial Hospital Belleville; Memorial Hospital Shiloh; HSHS St. Elizabeth's Hospital in O'Fallon, Illinois (not affiliated with Gateway)
- Nearby communities: Fairview Heights, O'Fallon, Illinois, St. Clair County, Illinois, Collinsville, Metro East
- Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation
Other conditions and nearby communities
Read the full guide to wounds with lymphedema, or see everything Gateway arranges on the mobile wound care in Belleville page.
- Diabetic foot ulcers
- 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
- Skin graft aftercare
- Wound VAC (NPWT) follow-up
- Wound care with lymphedema in Fairview Heights
- Wound care with lymphedema in O'Fallon
- Wound care with lymphedema in St. Clair County
- Wound care with lymphedema in Collinsville
Common questions
Do I need a referral to request lymphedema wound care in Belleville?
No. Patients, family members and caregivers can call Gateway directly at 314-325-0126 or send a callback request, with or without a referral. Some health plans have their own referral or authorization rules, and we ask about those when we confirm the treating provider. The web form asks only for a name and phone number, so please save medical details for the phone call.
Why does the skin on my swollen leg look thick and bumpy?
When protein-rich lymph fluid sits in the tissue for months or years, the skin responds by thickening and hardening. It may form deep creases at the ankle or grow small wart-like bumps, especially on the feet and toes. These changes are a sign of long-standing lymphedema. They make skin harder to keep clean and more likely to crack, so point them out to the treating clinician.
My arm is swollen after breast cancer treatment and the skin has opened. Can Gateway help?
You can ask us about any lymphedema wound, including one on an arm or hand. Arm lymphedema after lymph node surgery or radiation carries the same infection risk as leg lymphedema, and a new opening in the skin should be reported promptly. Let your oncology team know as well. Gateway can arrange an assessment with a partner clinician and share the findings with the clinicians who managed your cancer care.
Can a resident of a Belleville nursing home be seen for a pressure injury?
Gateway arranges visits from partner wound care clinicians in skilled nursing and rehabilitation settings, coordinated with the facility’s nursing staff. The treating clinician assesses the pressure injury, writes orders and reviews progress at later visits, while facility staff carry out daily care. Families can ask the facility about a referral or call us directly to start the request.
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.