About arterial and mixed wounds

Arterial and mixed wounds mostly affect older adults whose blood vessels have been under strain for decades. The people clinicians see most often include those who smoke or used to, people with diabetes, and people with high blood pressure, high cholesterol or chronic kidney disease, including those on dialysis. Many have already had a heart attack, a stroke, or a stent or bypass in a leg. Calf cramping that comes on with walking and eases with rest is a common earlier clue.

Mixed wounds tend to appear in people with a long history of leg swelling, varicose veins or a past venous ulcer who later develop artery disease on top of it.

What an assessment covers

Beyond the wound itself, the treating clinician gathers the history that explains it. Expect questions about:

  • How the wound started and how long it has been open
  • Pain: where, when, and what eases it
  • How far you can walk before your calves or feet hurt
  • Tobacco use, diabetes and past heart or vascular procedures
  • Shoes, slippers and whether you sleep in a bed or a recliner

The answers feed a plan with clear goals. For some people the aim is closure once circulation improves. For others, particularly when a procedure is not an option, the aim is comfort, protection and preventing infection.

Local context: Chesterfield and West County

In Chesterfield and West County, the adult son or daughter helping with an arterial wound often leaves for work early and gets home late. That leaves long daytime hours when nobody is looking at the foot. The treating clinician can set up a routine that fits a commuter’s schedule, such as a foot check before work and again in the evening, with written notes on what to report. Gateway schedules visits around the caregiver’s availability when possible and passes along updates by phone. For a parent moving into one of the newer senior living communities nearby, we coordinate with staff there too.

Chesterfield and West County have a wide range of places to live as people age. Many residents stay in the two-story houses where they raised families. Others move to ranch villas, condominiums, independent living apartments or senior communities with assisted living, memory care and skilled nursing on one campus. Gateway arranges visits from partner clinicians across this range. When a resident moves from one level of care to another, we update the address, the facility contacts and the records so the treating clinician’s plan follows the person.

When care happens at home

At a home visit, the treating clinician sees things a clinic never shows: the shoes by the door, the chair where you spend the afternoon, the bed where a heel rests all night. For an arterial wound those details matter, because pressure and rubbing on a poorly supplied foot can undo careful dressing work.

Gateway schedules the visit, gathers earlier vascular records and test results beforehand, and sends the clinician’s orders where they need to go afterward. For people whose leg pain limits walking, being seen at home removes the hardest part of getting care, which is the trip.

For residents of nursing and senior living communities

Many people arrive at a rehabilitation center after a hospital stay for a vascular procedure, an infection or a toe amputation, with a wound that still needs close follow-up. Therapy adds a complication: the foot has to bear weight and wear a shoe again.

The treating clinician works with facility nursing and therapists on how the wound is protected during sessions, and with the attending physician on orders. Gateway obtains the hospital’s operative and vascular reports, lines up any follow-up visit the surgeon requested, and plans how wound care will continue at home or in long-term care after discharge.

Changes to report

Arterial wounds can change quietly, so small differences are worth a call. Contact the treating clinician’s team promptly if you notice:

  • Pain that is stronger, or that now wakes you at night
  • A toe or patch of skin turning dusky, purple or black
  • The wound getting wider or deeper
  • New drainage or odor, or a dry scab turning soft
  • Redness or warmth spreading out from the wound

Call 911 if a foot or leg suddenly turns cold, pale or blue, goes numb, or becomes severely painful or hard to move. A sudden loss of blood flow is an emergency.

How primary care fits in

Peripheral artery disease is rarely limited to the legs. The same buildup that narrows a leg artery often affects the vessels of the heart and brain, which is why a foot wound from poor circulation leads clinicians to look at the whole person.

A primary care clinician manages blood pressure, cholesterol and diabetes, and reviews the medications prescribed to protect the heart and blood vessels. Gateway can arrange primary care alongside wound care, so the clinician dressing the wound and the clinician managing overall health share records and each knows what the other has ordered.

Primary care at home in Chesterfield and West County →

How to get started in Chesterfield and West County

To arrange arterial and mixed wound care in Chesterfield and West County, 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.

When you call, it helps to know the subdivision or community name as well as the street address, since some neighborhoods are gated and many streets end in cul-de-sacs. Tell us about gate codes, long driveways and which entrance a facility prefers for visitors. Have the patient’s doctor and pharmacy names handy. Gateway also arranges care in Ballwin, Wildwood, Creve Coeur, Maryland Heights, Ellisville and Des Peres, and visits in Chesterfield and West County are planned with those neighboring areas in mind. Availability is confirmed by location and setting.

  • County: St. Louis County, Missouri
  • ZIP codes: 63017, 63005
  • Nearby hospitals: St. Luke's Hospital in Chesterfield; Mercy Hospital St. Louis in Creve Coeur; Missouri Baptist Medical Center in Town and Country; Barnes-Jewish West County Hospital in Creve Coeur (not affiliated with Gateway)
  • Nearby communities: Chesterfield, Ballwin, Wildwood, Ellisville, Des Peres, Creve Coeur
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Related care in Chesterfield and West County

Read the full guide to arterial and mixed wounds, or see everything Gateway arranges on the mobile wound care in Chesterfield and West County page.

Common questions

If I see a vascular specialist near Chesterfield and West County, who keeps everyone informed?

Gateway does much of that work. When the treating clinician refers you to a vascular specialist, we send the wound records, help schedule the appointment, arrange transportation if needed and request the visit notes and test results afterward. Those go back to the wound care clinician and, with your permission, your primary care office. You should not have to carry messages between offices in or near Chesterfield and West County.

Can an arterial ulcer heal without a procedure to open the artery?

Some do and some do not. It depends mainly on how much blood is reaching the area, along with infection, diabetes control and overall health. The treating clinician and, when involved, a vascular specialist weigh whether local wound care is likely to be enough or whether improving blood flow should come first. Not everyone is a candidate for a procedure, and in that case the plan centers on protection and comfort.

Is walking good or bad when I have a foot wound from poor circulation?

Walking is commonly recommended for artery disease in general, but an open wound on the foot changes the picture. Pressure and rubbing can hold a wound back, and the right shoe or protective device matters. Ask the treating clinician how much to walk, what to wear on the foot and whether any part of it should be kept free of weight. The answer is individual.

Are homes in the western part of Chesterfield and West County, out along Wild Horse Creek Road, too far for visits?

They are within the area where Gateway arranges care. The western part of Chesterfield has longer drives between homes, so visits there may be grouped on particular days. Tell us the address and any details about gates or private roads. We confirm availability for the location and care setting, and we will tell you plainly if a visit cannot be arranged where you are.

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.