About arterial and mixed wounds
Leg arteries narrow slowly as fatty deposits build up inside their walls, a condition called peripheral artery disease. For years the body copes by widening smaller side vessels. Then demand rises: a blister from a new shoe, a nick while trimming a nail, a scrape against a wheelchair footrest. Repairing an injury takes far more oxygen than keeping intact skin alive, and the narrowed arteries cannot supply the difference. The injury stalls and becomes an ulcer.
In a mixed wound, weak vein valves add a second problem. Fluid pools in the lower leg, the tissue swells and the skin breaks down more easily, while the limited arterial flow slows every stage of repair.
What an assessment covers
The first visit is as much about the leg as the wound. The treating clinician feels for pulses at the ankle and on top of the foot, compares the temperature and color of both feet, and checks how quickly color returns to a toe after gentle pressure. The wound is measured, and its base, edges and drainage are described.
Then comes the question that shapes everything else: is there enough arterial flow for this wound to heal? If the answer is unclear, the clinician may order circulation testing before choosing dressings, deciding whether dead tissue should be removed, or allowing any compression.
Arranging this care in Creve Coeur
People in Creve Coeur often move between settings without going far: a hospital stay for a vascular procedure, a few weeks in a nearby skilled nursing or rehabilitation center, then home or to a senior living community close by. An arterial wound has to be followed through each move, and orders about compression, dressings and weight on the foot must travel with it. Gateway keeps the wound records and the treating clinician’s current orders together across those handoffs, so each new nursing team starts from the same plan and the family is not left carrying paperwork.
The housing in Creve Coeur leans toward ranch homes and two-story houses on generous lots, joined by condominium complexes, apartments and a number of senior living communities. Independent living, assisted living, memory care and skilled nursing can all be found in or next to the city. Gateway arranges partner clinician visits wherever the patient lives. In a house, we plan around the family’s day. In a senior community, we find out whether the resident or the staff handles dressing changes between visits, so the treating clinician’s orders go to the right hands.
At home between visits
Family caregivers are often the first to notice trouble with an arterial wound, because they see the foot every day. The treating clinician can show a spouse, adult child or paid aide what the wound should look like, how the dressing is handled under the current orders, and which changes call for a phone call.
Caregivers also help in quieter ways: checking that socks and shoes are not leaving marks, keeping walkways clear so toes are not stubbed, and making sure bedding is not pressing on sore toes at night. Gateway can include a caregiver on scheduling calls and updates when the patient agrees.
Care in skilled nursing and assisted living
Assisted living staff usually help with daily routines but may not perform wound care, so arterial wounds in these communities often involve a home health agency, the resident’s own physician and family. Gateway helps connect those pieces. The treating clinician visits the resident’s apartment, and we share the plan with the nurse or wellness director, the agency and the family contact.
Aides who help with bathing and dressing can be told what to watch for on the feet, such as a new dark spot on a toe or a sock that leaves a deep groove, and whom to tell when they see it.
What to report and when to call 911
Infection can move fast in tissue that is short on blood, and the usual warmth and redness may be faint. Report promptly:
- A dry wound that becomes wet, soft or foul-smelling
- Red streaks or swelling moving up the foot or leg
- Fever, chills, or new confusion in an older adult
- Blood sugar running higher than usual, if you have diabetes
- A sudden rise in pain
Call 911 for a suddenly cold, pale or blue limb, severe pain with numbness or loss of movement, bleeding that will not stop, or a fever that comes with fainting, a racing heart or confusion.
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.
Arranging arterial and mixed wound care in Creve Coeur
Before anything is scheduled, Gateway checks two things for every request for arterial and mixed wound care in Creve Coeur: whether a partner clinician serves that address and care setting, and what the patient’s plan requires from the treating provider. Neither is assumed. If both line up, we arrange the visit and gather records. If something stands in the way, we say so, and our guide to following up on a request explains what to ask next. Gateway coordinates the care and does not make clinical decisions. Those belong to the treating clinician who sees the wound. Start by calling 314-325-0126, or ask a family member to call for you.
To arrange care in Creve Coeur, start with the basics: the patient’s full name, the address in 63141, a callback number and the name of the primary care physician. If the person lives in a senior community, add the apartment number and the nurse’s station phone. Because Creve Coeur sits at the junction of Olive Boulevard and Interstate 270, visits can be planned along with Maryland Heights, Ladue, Overland, Des Peres, University City and Chesterfield. Let us know about days that will not work, such as dialysis or therapy days.
- County: St. Louis County, Missouri
- ZIP codes: 63141
- Nearby hospitals: Mercy Hospital St. Louis in Creve Coeur; Barnes-Jewish West County Hospital in Creve Coeur; Missouri Baptist Medical Center in Town and Country (not affiliated with Gateway)
- Nearby communities: Chesterfield, Maryland Heights, Chesterfield and West County, Ladue, Overland, Des Peres
- Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation
Related care in Creve Coeur
Read the full guide to arterial and mixed wounds, or see everything Gateway arranges on the mobile wound care in Creve Coeur page.
- Diabetic foot ulcers
- Venous leg ulcers
- Pressure injuries and bed sores
- 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
- Arterial and mixed wound care in Maryland Heights
- Arterial and mixed wound care in Chesterfield and West County
- Arterial and mixed wound care in Ladue
Common questions
Do I need a referral to ask about arterial wound care in Creve Coeur?
No. Patients, family members and caregivers in Creve Coeur can contact Gateway directly, and hospitals, facilities and physician offices can refer as well. Some health plans do require a referral or authorization before certain visits or tests, and the treating clinician may need earlier records. We explain what is needed for your situation after the first call, before a visit is scheduled.
What is an ankle-brachial index, and does it hurt?
It is a common circulation test. Blood pressure cuffs are placed on the arms and ankles, and a small handheld ultrasound device listens to the pulse while each cuff is inflated. Comparing ankle and arm pressures shows whether blood flow to the foot is reduced. The cuff squeeze can be uncomfortable for a moment, especially near a sore area, so tell the person doing the test where your wound is.
How can one wound be both arterial and venous?
The legs have two sets of vessels. Arteries carry blood down to the foot and veins carry it back up. Many older adults have disease in both. When weak veins cause swelling and skin breakdown on a leg where the arteries are also narrowed, the result is a mixed wound. It often looks like a venous ulcer, which is why clinicians check arterial flow before treating it as one.
What should a caregiver in Creve Coeur do if a wound looks worse between visits?
Report it. Call Gateway at 314-325-0126 so the message reaches the treating clinician, and describe what changed: more redness or swelling, new drainage or odor, increasing pain, or fever. Do not change the treatment on your own. Call 911 instead for bleeding that will not stop, chest pain, trouble breathing, or sudden confusion or weakness. Gateway is not an emergency service.
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.