Understanding venous leg ulcers
Leg veins have to push blood uphill. They rely on two helpers: one-way valves inside the vein, and the calf muscle, which squeezes the veins with every step. When valves wear out or are damaged by an old blood clot, blood slips backward and collects near the ankle. Pressure in those veins stays high whenever you sit or stand.
That pressure forces fluid and blood cells out into the tissue, which swells, stiffens and receives less oxygen and nourishment than healthy skin. Skin in that state is easy to injure and slow to mend. A scrape from a walker, an insect bite or scratching an itchy patch can be enough to start an ulcer.
What the treating clinician looks at
Most care plans for a venous leg ulcer are built from the same parts, each set by the treating clinician for your leg:
- Compression, if circulation allows it
- A dressing schedule based on drainage
- Cleansing and protection for the surrounding skin
- Removal of unhealthy tissue when the clinician judges it necessary
- Guidance on elevation, walking and ankle movement
- A date to remeasure and review
The clinician writes the orders. Gateway then coordinates what the orders require: supplies, the visit schedule, and copies of the plan for home health, facility nursing or your primary care clinician. If the ulcer is not responding, the plan is reviewed and changed.
Venous leg ulcer care in Chesterfield and West County
In Chesterfield and West County, a vein specialist or vascular lab can be a long drive away, and a car ride is hard on a venous ulcer. Sitting with the knees bent and feet on the floor for a long stretch each way lets fluid settle in the lower legs. When routine wrap changes and wound checks happen at home, those drives can be saved for appointments that truly need a specialist’s equipment. Gateway arranges home visits with a partner clinician, helps schedule any testing the clinician orders, and groups appointments where possible so one trip covers more than one need.
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
When a home health agency is already visiting, its nurses commonly change dressings and reapply compression between the treating clinician’s visits. Gateway shares current orders with the agency so both work from the same plan, and we pass the nurses’ observations back. Supplies need the same attention. A draining venous ulcer can go through a large amount of absorbent dressings, padding and wrap layers in a week. We coordinate orders for the supplies the clinician specifies and check in before they run low. What a health plan pays for depends on the plan, the treating provider and the care needed.
For residents of nursing and senior living communities
A short rehabilitation stay after surgery or a hospital admission can be a turning point for a venous leg ulcer. Legs often swell more after days in bed and long hours in a wheelchair with the feet down. Therapy sessions, on the other hand, rebuild the walking and ankle movement that help veins work. Partner clinicians see patients on site and coordinate with nursing and therapy on details such as wrap changes around therapy times and footwear that fits over compression. Before discharge, Gateway helps line up continued visits and supplies at home so the plan does not lapse during the move.
What to report and when to call 911
Venous leg ulcers can become infected, and infection in the skin of the leg can spread. Report these changes to the treating clinician promptly:
- Redness, warmth or swelling that is spreading beyond the ulcer
- Pain that is getting worse instead of better
- Thick, cloudy or foul-smelling drainage
- Fever, chills or feeling generally unwell
- An ulcer that is suddenly larger or deeper
Call 911 for chest pain, shortness of breath, confusion or fainting, or bleeding from the leg that does not stop with firm, steady pressure.
Why primary care matters here
Venous disease is a long-term condition, and the ulcer is one episode in it. Once the skin closes, someone needs to keep watching the legs, renew orders for compression garments as they wear out, and decide whether a referral to a vein specialist makes sense. That ongoing role usually belongs to primary care. A primary care clinician also weighs how other treatments affect the leg, such as blood thinners after a clot or a change in blood pressure medicine. For patients without a regular clinician, or who can no longer get to an office, Gateway can arrange primary care visits alongside wound care so follow-up continues.
How to get started in Chesterfield and West County
People asking about venous leg ulcer care in Chesterfield and West County usually want to know what the first visit involves. Before it, Gateway collects the records the treating clinician asks for and confirms the time and place with you. During it, the clinician looks at the wound and the skin around it, measures it, asks about your health and medications and explains what they recommend. Afterward, the orders go to whoever does the daily care, supplies are requested and a follow-up is planned. Our guide to how mobile wound care visits work has more. To begin, call 314-325-0126. Whether a visit can be arranged is confirmed for your location.
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 venous leg ulcers, or see everything Gateway arranges on the mobile wound care in Chesterfield and West County 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 Ballwin
- Venous leg ulcer care in Wildwood
- Venous leg ulcer care in Creve Coeur
Common questions
Who arranges long-term compression garments for patients in Chesterfield and West County once an ulcer has closed?
The treating clinician or your primary care clinician decides whether you need ongoing compression and at what strength. Garments usually require measuring, and they wear out and need replacing. Gateway can coordinate the order, the fitting and reminders for replacement, and can arrange primary care follow-up if you do not have a regular clinician. Payment for garments depends on your plan.
Could a leg ulcer that will not heal be something other than a venous ulcer?
Yes. Poor arterial circulation, diabetes, pressure, inflammatory conditions, certain infections and, rarely, skin cancer can all cause leg wounds that resemble venous ulcers. That is one reason the clinician reassesses an ulcer that is not responding as expected. Further circulation testing, lab work, a tissue sample or a specialist referral may be ordered. Raise the question directly if you are worried.
Can I shower or bathe with a compression wrap on?
Most wraps need to stay dry, because a wet wrap can irritate skin and lose its hold. How you bathe depends on the type of compression ordered. Some garments come off for bathing, while layered wraps usually stay on until the next change. Ask the treating clinician what applies to you and which cover, if any, they suggest. Report a wrap that gets wet.
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.