About venous leg ulcers

Several common beliefs about venous leg ulcers get in the way of healing. One is that the sore needs air so it can dry out and scab. In general, clinicians aim for a moist, protected wound, not a dry one. Another is that the dressing does the healing. The dressing manages drainage, while compression addresses the swelling that holds the ulcer open.

A third is that resting means sitting with the feet on the floor, which lets fluid collect. People also assume a red, weeping leg must be infected, when skin inflamed by vein disease can look much the same. Each of these is worth raising with the treating clinician.

What an assessment covers

A plan for a venous leg ulcer has to work on ordinary days, so the treating clinician looks at how you live with the leg. Can you bend far enough to reach your foot? Do your hands have the grip to pull on a stocking? Who is in the house to help, and how often? What shoes fit over a wrap?

The answers guide the kind of compression that is ordered. Layered wraps applied by a clinician suit some people. An adjustable garment that a caregiver can manage suits others. A plan that fits your routine is more likely to stay on the leg, and compression only helps while it is worn.

Local context: Creve Coeur

Many people with venous leg ulcers in Creve Coeur have lived in the same house for decades, and some later move to a senior living community or skilled nursing facility a short drive away. The ulcer plan should move with them. Gateway keeps track of the measurements, compression orders and supply details, so when someone goes from home to a rehabilitation stay and back, the receiving nurses know what was on the leg and why. Because partner clinicians see patients in both homes and facilities, the plan can often continue without starting the assessment over.

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.

When care happens at home

Most of the healing in a venous leg ulcer happens between visits. The treating clinician leaves instructions for those days: how long a wrap stays on, how to keep it dry, when to put your feet up, and what to do if a wrap slides down. If a wrap comes off early or drainage soaks through, call instead of waiting for the next scheduled visit. Gateway takes those calls, relays the question to the clinician and arranges whatever follows, such as a supply shipment or an earlier visit when one is available. Writing down questions as they come up makes each visit more useful.

In a facility

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

Changes in the skin around a venous ulcer are worth reporting even when the wound itself looks the same. Let the treating clinician know about:

  • Dressings that soak through earlier than expected
  • Skin near the ulcer that turns white, soggy or raw
  • A new itchy rash or blisters under a dressing, tape or wrap
  • A new open area anywhere on either leg
  • Clear fluid weeping from skin that was intact
  • A dressing or wrap that got wet or dirty

Call 911 if bleeding will not stop with firm pressure, or if the person becomes confused, very drowsy or hard to wake.

Primary care and overall health

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.

Primary care at home in Creve Coeur →

How to get started in Creve Coeur

Setting up venous leg ulcer care for someone in Creve Coeur usually goes in this order:

  1. You call 314-325-0126 or send the request care form, which asks only for a name and phone number.
  2. Gateway talks with you about the wound, the address and the insurance.
  3. We confirm availability for that location and gather records for the treating clinician.
  4. The clinician visits, assesses the wound and writes the orders.
  5. We follow up on supplies, the next visit and communication with your other clinicians.

You do not need a confirmed diagnosis to start.

Mercy Hospital St. Louis and Barnes-Jewish West County Hospital are both in Creve Coeur, and Missouri Baptist Medical Center in Town and Country is a short drive south. Gateway is not affiliated with these hospitals. A surgical or chronic wound often still needs attention after the patient goes home. Case managers can fax us a referral before discharge. Families can call with the hospital name and going-home date. Gateway requests the records, confirms the Creve Coeur address and setting, and arranges a follow-up visit with a treating clinician.

  • 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

More wound care in Creve Coeur

Read the full guide to venous leg ulcers, or see everything Gateway arranges on the mobile wound care in Creve Coeur page.

Common questions

Can a clinician come to a home in Creve Coeur to care for a venous leg ulcer?

In many cases, yes. Gateway arranges visits from partner clinicians to private homes, and we confirm availability for your address and care setting when you call. The clinician assesses the leg, writes the orders and returns on the schedule they set. Call 314-325-0126 to ask. For anything life-threatening, call 911 instead.

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.

How often will someone visit for a venous ulcer?

The treating clinician sets the schedule based on the leg. Heavy drainage or newly started compression often calls for more frequent changes, and visits may spread out as swelling and drainage settle. Home health nurses or facility staff sometimes handle changes in between. Gateway cannot promise a specific frequency or timing, since availability is confirmed by location and care setting.

Can a physician office in Creve Coeur refer a patient to Gateway?

Yes. Offices in Creve Coeur can refer by fax at 314-786-7966 or by phone at 314-325-0126. Include the patient’s contact details, the reason for referral and recent notes. Gateway checks availability for the patient’s home or facility and keeps the referring office informed after the visit. The patient does not have to live in Creve Coeur for a local office to refer.

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.