About diabetic foot ulcers
Most diabetic foot ulcers begin with pressure or friction that the person never feels. Years of high blood sugar can damage the nerves that carry pain and temperature signals from the feet, so a pebble in a shoe, a tight seam or hot pavement does its harm unnoticed. The same nerve damage can dry the skin until it cracks, and it can weaken the small muscles of the foot so the toes curl and bones press down in new places. Callus builds over those pressure points, and the tissue underneath breaks down. When narrowed arteries also limit the blood supply, the skin is less able to repair small injuries, and a minor break becomes an open wound.
What an assessment covers
Clinicians grade diabetic foot ulcers by severity, and the grade shapes what follows. A shallow wound with good blood flow and no infection can often be managed with visits at home or in a facility. A wound with spreading infection, exposed bone or tendon, or poor circulation may need a hospital, a surgeon or a vascular specialist, and the treating clinician will tell you if that is the case. Between those two ends, the clinician weighs what can be done on site against what calls for imaging, lab work or a specialist’s opinion. Gateway’s part is to move the resulting orders and referrals along and to let you know who should be calling you.
Diabetic foot ulcer care in Chesterfield and West County
Many newer homes in Chesterfield and West County have a garage entry with few steps and a main-floor room that can serve as a bedroom, which makes offloading easier to follow than in an older house. The harder part is distance. Specialists and testing sites may be miles away, so when a partner clinician orders a circulation study or imaging, Gateway looks at grouping appointments into fewer trips and arranging transportation. Dressings and devices are ordered ahead with delivery time in mind. Senior living communities are growing in this part of the region, and residents there can ask about on-site wound visits.
West County spreads out from Chesterfield along Interstate 64 and Olive Boulevard, from the bluffs above the Missouri River to the wooded subdivisions farther south. The area is suburban and car-dependent, with offices and shopping in Chesterfield Valley and neighborhoods of large lots and cul-de-sacs on the higher ground. Gateway’s administrative office is here in Chesterfield, though no patients are seen at it. Care happens where people live. For residents of Chesterfield and West County who cannot easily ride to a clinic, that means a clinician at the front door or at the facility bedside.
Care at home
Most of the time a foot ulcer spends healing falls between visits, so the plan for those days matters. The treating clinician will spell out how often the dressing is changed, who changes it, how much walking is allowed and what goes on the foot indoors, including short trips to the bathroom at night. Keeping the offloading boot or shoe beside the bed makes those trips easier to do correctly. A simple daily routine helps: look at both feet, check whether drainage has soaked through the dressing, and write down anything new. If a question comes up, call Gateway and we will pass it to the treating clinician.
For residents of nursing and senior living communities
A resident with dementia may not remember having a foot wound, may pull off a dressing, or may refuse a boot that feels strange. Memory care teams know these patterns, and the treating clinician plans with them. That can mean choosing dressings that stay in place, timing care for a calmer part of the day, and asking staff which footwear the resident will keep on. Because the resident often cannot report pain or changes, staff observations carry extra weight. Gateway relays those observations to the clinician between visits and helps keep family members or legal decision-makers informed about the plan.
Signs to tell the clinician about
Infection is the change clinicians most want to hear about early, and in a numb foot it may not hurt. Contact the treating clinician promptly if you notice:
- Redness that is spreading, or a red streak moving up the foot or leg
- Skin around the ulcer that feels warmer than the other foot
- Thicker, cloudy or foul-smelling drainage
- New swelling of the foot or ankle
- Fever, chills or feeling generally unwell
Call 911 for confusion, a racing heart, trouble breathing or fainting. Gateway is not an emergency service.
Why primary care matters here
Healing an ulcer takes protein, calories and fluids, and that can pull against an eating plan built around blood sugar or kidney disease. Sorting out what to eat while a wound is open is a question for the primary care clinician or a dietitian. Medications deserve the same review. Some can affect swelling, blood sugar or healing, and only the prescribing clinician should adjust them. Arranging wound care and primary care together means these questions are asked by someone with the full medication list and recent lab results in hand, not saved for an appointment that is months away.
Getting care arranged in Chesterfield and West County
If you have been managing a wound mostly on your own and are looking for diabetic foot ulcer care in Chesterfield and West County, 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.
Four hospitals serve most of the area: St. Luke’s Hospital in Chesterfield, Mercy Hospital St. Louis and Barnes-Jewish West County Hospital in Creve Coeur, and Missouri Baptist Medical Center in Town and Country. Gateway is not affiliated with any of them. For discharge planners, a faxed referral with the face sheet, wound orders and destination is enough to start. For families, a phone call does the same. We gather records from the hospital, check availability at the home or facility in Chesterfield and West County, and arrange the first visit with a treating clinician.
- 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
More wound care in Chesterfield and West County
Read the full guide to diabetic foot ulcers, or see everything Gateway arranges on the mobile wound care in Chesterfield and West County 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 Ballwin
- Diabetic foot ulcer care in Wildwood
- Diabetic foot ulcer care in Creve Coeur
Common questions
My parent lives in a nursing home in Chesterfield and West County. Can Gateway arrange foot ulcer visits there?
You can ask, and we will confirm availability for that building. Partner clinicians see residents in skilled nursing, assisted living, memory care and rehabilitation settings. A facility has its own attending physician and nursing staff, so we coordinate with them before scheduling. Call us, or ask the director of nursing to send a referral. Updates go to family when the resident or legal representative agrees.
What is Charcot foot, and is it related to foot ulcers?
Charcot foot is a condition in which the bones and joints of a numb foot weaken and shift, sometimes after a minor injury that was never felt. The foot may become red, warm and swollen with no open wound. As its shape changes, new pressure points form and ulcers can follow. It needs prompt evaluation, so report a suddenly swollen, warm foot to a clinician even if the skin is intact.
What is offloading, and why does everyone keep bringing it up?
Offloading means taking pressure off the part of the foot where the ulcer is. It may involve a cast, a removable boot, a special shoe, padding or limits on walking. Clinicians stress it because skin cannot rebuild while it is pressed against the ground with every step. The treating clinician chooses the method, and it helps only during the hours it is actually worn.
Gateway has an office in Chesterfield. Can patients from Chesterfield and West County be seen there?
No. The Chesterfield office is administrative only. It handles phone calls, scheduling, records and coordination, and no patients are examined or treated there. Care is delivered by partner clinicians in homes, senior living communities, skilled nursing facilities and some outpatient settings with clinical partners. To get started, call 314-325-0126 or send the request form with a name and phone number, and we will call you back.
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.