Venous leg ulcer care in Clayton and Central County.

What to know about venous leg ulcers

Venous leg ulcers are more common in older adults, but age is not the only factor. People who have had a blood clot in a leg vein, varicose veins, leg surgery or a serious leg injury carry more risk. So do people who stand or sit for most of the day, people with a higher body weight, and women who have had several pregnancies. A family history of vein trouble is common.

Anything that keeps the ankle from bending, such as arthritis, an old fracture or weakness after a stroke, also plays a part. Many people notice years of warning signs first: ankles that swell by evening, legs that feel heavy, and skin that slowly darkens above the ankle.

What an assessment covers

A first visit for a venous leg ulcer covers more than the wound. The treating clinician typically records:

• Where the ulcer sits, and its length, width and depth
• The appearance of the wound base and edges
• How much drainage there is and what it looks like
• The surrounding skin: staining, hardening, rash, or pale soggy areas
• Swelling in both legs, often measured at the ankle and calf
• Pain, and what makes it better or worse

Those findings become the baseline. The same points are checked again at later visits, so the care plan is adjusted on what the leg is doing, not on guesswork.

Local context: Clayton and Central County

Homes in Clayton and Central County are often older houses with upstairs bedrooms, basement laundry and a bathtub you have to step over. Each matters with a wrapped leg. Climbing in and out of a tub while keeping compression dry is a fall risk, and stairs may be the reason someone starts sleeping in a recliner with the legs down. During a home visit, the treating clinician can see all of this and suggest practical changes, and Gateway can coordinate ordered equipment such as a shower chair or a leg-elevating cushion. For long-time residents who want to stay put, those details matter.

You will find nearly every kind of home in Clayton and Central County: high-rise condos with a front desk, older brick apartment buildings without elevators, two-story houses, duplexes and bungalows in the inner suburbs. Senior living is well represented too, from independent apartments to assisted living, memory care and skilled nursing and rehabilitation. Gateway arranges partner clinician visits in each setting. We ask about elevators, entry and parking for apartment and condo visits, and we work with facility nurses on timing so a visit does not collide with therapy or meals.

When care happens at home

Family caregivers often carry part of the work for a venous leg ulcer at home. Depending on the orders, that might mean helping with a stocking or adjustable garment, changing an outer dressing, propping the legs at rest, or watching the toes and skin for changes. No one should have to guess. The treating clinician can show a caregiver which tasks are theirs and which to leave alone, and Gateway can request visit times when the caregiver is able to be there. If the caregiver works, travels or lives elsewhere, tell us, and with your permission we will keep them informed by phone.

For residents of nursing and senior living communities

Residents in memory care may not understand why a leg is wrapped. They may pull at the bandage, scratch the skin beneath it or be unable to say that it feels too tight. The treating clinician takes that into account when choosing dressings and compression, and may adjust the plan when a resident does not tolerate a wrap. Staff observations carry extra weight here. Restlessness, guarding the leg, a change in walking or a new refusal to wear shoes can all signal discomfort. Gateway shares the clinician’s instructions with the care team and keeps the family or legal representative updated on visits and changes.

What to report and when to call 911

Compression should feel snug and supportive, not painful. Contact the treating clinician promptly if any of these occur while a wrap or garment is on:

• Toes that look pale, bluish or darker than usual, or feel cold
• Numbness, tingling or pins and needles in the foot
• New or sharper pain under the wrap, particularly over the shin or ankle
• A wrap that has rolled, slid down or formed a tight band
• Swelling that bulges above or below the wrap

Follow the instructions you were given for these situations, including whether to take the wrap off. Call 911 if the foot or leg suddenly turns cold, pale and severely painful.

How primary care fits in

A draining venous ulcer asks a lot of the body. Protein is lost in wound fluid, and healing skin needs steady calories, protein and fluids to rebuild. Older adults with a poor appetite, dental problems or a tight food budget can fall behind without anyone noticing. A primary care clinician can check weight trends and lab work, look for anemia, and review diabetes control, since high blood sugar slows repair and raises infection risk. Body weight matters as well, because extra weight adds pressure to leg veins. None of this replaces wound care. It supports it, which is why Gateway can arrange both.

Primary care at home in Clayton and Central County →

Arranging venous leg ulcer care in Clayton and Central County

To arrange venous leg ulcer care in Clayton and Central 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.

For people in Clayton and Central County, the nearest hospital is usually SSM Health St. Mary’s Hospital in Richmond Heights. Many also go east to Barnes-Jewish Hospital or west to Missouri Baptist Medical Center in Town and Country. Gateway has no affiliation with these hospitals. A discharge planner can refer by fax, and a family member can call us while the patient is still admitted. We ask for the discharge summary and wound orders, verify the address the patient is returning to, and arrange follow-up with a treating clinician who directs wound care from that point.

• County: St. Louis County, Missouri
• ZIP codes: 63105, 63117, 63124
• Nearby hospitals: SSM Health St. Mary's Hospital in Richmond Heights; Barnes-Jewish Hospital; Missouri Baptist Medical Center in Town and Country (not affiliated with Gateway)
• Nearby communities: Richmond Heights, University City, Ladue, Brentwood, Maplewood, Central West End
• Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

More wound care in Clayton and Central County

Read the full guide to venous leg ulcers, or see everything Gateway arranges on the mobile wound care in Clayton and Central 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 University City
• Venous leg ulcer care in Ladue
• Venous leg ulcer care in the Central West End

Common questions