About wounds with lymphedema
Wounds form on a limb with lymphedema because swollen tissue is fragile tissue. Fluid pushes skin cells farther from the small blood vessels that feed them, so oxygen and nutrients arrive slowly. The stretched surface tears easily, and a scratch from a pet, a bump against a bed frame or a rubbing shoe can open it.
Once the skin is open, lymph fluid seeps out. The steady moisture softens the surrounding skin until it turns white and breaks down, and the open area widens. Bacteria that would normally be carried away by lymph flow linger in the tissue. Each problem feeds the next, which is why treating clinicians usually address the swelling and the wound in the same plan.
What the treating clinician looks at
During the exam, the treating clinician looks at the wound and at all of the skin on the limb, since the next problem often starts a few inches from the current one. Typical points of attention include:
- Where the wound sits, its size and depth, and what the wound bed looks like
- How much it drains and what the fluid looks like
- Skin folds, including the base of each fold
- The spaces between the toes, where cracks and fungal infections hide
- Warmth, redness or tenderness that could mean infection
These findings guide the choice of dressing, how often it is changed, and whether an infection has to be dealt with before anything else.
Arranging this care in Chesterfield and West County
In many households in Chesterfield and West County, the family member who helps with wraps leaves early for work and gets home late. That leaves a long stretch when a wrap that slips or a dressing that soaks through has no one to fix it. Tell the treating clinician about the household schedule. Orders can sometimes be built around it, and home health nursing during the day may be an option. If your relative lives in one of the newer senior living communities, Gateway coordinates with the staff there as well.
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
Most of the work on a lymphedema wound happens between visits. The treating clinician leaves instructions for the days in between, and they usually cover washing and thoroughly drying the skin, using a moisturizer if one is ordered, keeping wraps or garments on as directed and resting with the limb raised.
Wraps slip, dressings soak through and questions come up. Ask at the visit whom to call when that happens and what to do in the meantime, so no one is left guessing on a weekend. If part of the routine is not working, say so. A plan can be adjusted, but only if the clinician hears about the problem.
Care in skilled nursing and assisted living
Rehabilitation stays are hard on swollen legs. Long sessions in a wheelchair with the feet down let fluid pool, and wraps can loosen or slide during therapy. The treating clinician works with physical and occupational therapists on timing and positioning, such as when wraps are checked, how leg rests are used and how much ankle movement and walking can be built into the day.
Discharge needs planning too. Before the resident goes home, someone has to know who will apply compression, where supplies will come from and who follows the wound. Gateway can arrange for visits to continue at home, with availability confirmed by location.
Changes to report
Skin infection is the complication to watch most closely with lymphedema, because it can spread through a swollen limb quickly. Contact the treating clinician promptly if you notice:
- Redness that is new or spreading, or red streaks running up the limb
- Skin that feels hot or newly tender
- Fever, chills or body aches
- Drainage that turns cloudy, thick or foul smelling
- Pain that is clearly worse than usual
Do not wait for the next scheduled visit to mention these. Call 911 if a person with these signs becomes confused, faint, very drowsy or short of breath.
Why primary care matters here
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 Chesterfield and West County
Setting up wound care with lymphedema for someone in Chesterfield and West County usually goes in this order:
- You call 314-325-0126 or send the request care form, which asks only for a name and phone number.
- Gateway talks with you about the wound, the address and the insurance.
- We confirm availability for that location and gather records for the treating clinician.
- The clinician visits, assesses the wound and writes the orders.
- We follow up on supplies, the next visit and communication with your other clinicians.
You do not need a confirmed diagnosis to start.
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 wounds with lymphedema, or see everything Gateway arranges on the mobile wound care in Chesterfield and West County 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 Ballwin
- Wound care with lymphedema in Wildwood
- Wound care with lymphedema in Creve Coeur
Common questions
Do I need a referral to request lymphedema wound care in Chesterfield and West County?
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.
Can I shower with a lymphedema wound and compression wraps?
Ask the treating clinician, because the answer depends on the dressing and the type of compression. Some wraps are meant to stay on and stay dry for several days, while others come off daily. Clean skin matters a great deal with lymphedema, so the clinician will explain how washing fits into your routine and how to protect anything that must not get wet.
Why do I keep getting cellulitis in the same leg?
A limb with lymphedema clears bacteria slowly, so germs that get in through a crack, a blister or peeling skin between the toes can take hold quickly. Each infection can scar more lymph vessels, which adds swelling and sets up the next one. Tell your clinicians how often it has happened. They can look for the entry points and decide what prevention makes sense for you.
Which communities does Gateway include with Chesterfield and West County?
Chesterfield itself, in ZIP codes 63017 and 63005, plus the West County communities around it. Gateway also arranges care in Ballwin, Ellisville, Wildwood, Creve Coeur, Maryland Heights and Des Peres. If you are unsure which name fits your address, do not worry about it. Give us the street address and ZIP code, and we will check availability 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.