Understanding 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 the treating clinician looks at
Before anything is wrapped, the treating clinician needs to know that the arteries in the leg can tolerate pressure. That usually means feeling for pulses in the foot, and often a bedside test that compares blood pressure at the ankle with blood pressure in the arm. If the result is unclear, further vascular testing may be ordered.
This step matters because some leg ulcers involve both vein and artery disease, and those call for a different plan. Once circulation is understood, the clinician decides whether compression is appropriate, which form to use and how firm it should be. The dressing choice follows, matched mainly to how much the ulcer drains.
Local context: Madison County, Illinois
On the Illinois side of the river, venous ulcer care involves a different set of health plans and hospitals. If you live in Madison County, your coverage may be Illinois Medicaid, a Medicare Advantage plan offered in Illinois, or an employer plan, and each has its own rules for visits, compression garments and dressings. Gateway confirms the treating provider and your plan details before the first visit, so you know where things stand. We cannot say in advance what a plan will pay. Benefits depend on the treating provider, the plan and the care needed.
Across Madison County you will find older houses on city lots, newer subdivisions, farmhouses and apartments, along with independent and assisted living, memory care, rehabilitation centers and skilled nursing facilities in the larger towns. Gateway arranges wound care and primary care visits with partner clinicians in each of these settings. The steps differ a little from one to the next. At home, we plan around the household and whoever helps with care. In a facility, we plan around the staff, the chart and the resident’s daily routine.
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.
Care in skilled nursing and assisted living
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.
Signs to tell the clinician about
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.
Why primary care matters here
Not all leg swelling comes from the veins. The heart, kidneys, liver and thyroid can each cause fluid to build up, and so can certain medicines for blood pressure, pain or diabetes. Sorting out which causes apply is primary care work, usually involving an exam, a medication review and sometimes blood tests or heart testing. That information changes wound care. A clinician planning compression wants to know, for example, whether heart failure is present and how stable it is. When Gateway arranges wound care and primary care together, findings move in both directions and the leg is not handled as if it were separate from the person.
How to get started in Madison County
You may already have a surgeon, a wound clinic or a home health nurse and still want help with venous leg ulcer care closer to home in Madison County. That is a fine reason to call 314-325-0126. Tell us who is treating the wound now and what is not working, whether that is the travel, the gaps between appointments or unclear instructions. Gateway does not replace your current clinicians. We can arrange for a partner clinician to see the wound where you live and, with your permission, share notes with the offices already involved so the plans agree.
Madison County patients are discharged from several hospitals: Anderson Hospital in Maryville, Alton Memorial Hospital, OSF Saint Anthony’s Health Center in Alton, Gateway Regional Medical Center in Granite City and HSHS St. Joseph’s Hospital in Highland. Gateway Wound Care is not affiliated with any of them, and follow-up can be requested no matter where the stay took place. A family member or discharge planner tells us where the patient is headed, whether home or a facility. We then obtain the discharge orders and arrange a visit with a partner clinician once availability for that location is confirmed.
- County: Madison County, Illinois
- ZIP codes: 62025, 62034, 62234, 62040, 62002, 62035
- Nearby hospitals: Anderson Hospital in Maryville; Alton Memorial Hospital; OSF Saint Anthony's Health Center in Alton; Gateway Regional Medical Center in Granite City; HSHS St. Joseph's Hospital in Highland (not affiliated with Gateway)
- Nearby communities: Edwardsville, Glen Carbon, Collinsville, Granite City, Alton, Godfrey, Illinois
- Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation
More wound care in Madison County
Read the full guide to venous leg ulcers, or see everything Gateway arranges on the mobile wound care in Madison 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 Edwardsville
- Venous leg ulcer care in Glen Carbon
- Venous leg ulcer care in Collinsville
- Venous leg ulcer care in Granite City
Common questions
Who arranges long-term compression garments for patients in Madison 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.
My mother lives in a nursing home in Madison County. Can Gateway arrange venous ulcer care there?
Often, yes. Partner clinicians see residents in skilled nursing, assisted living, memory care and rehabilitation settings, working alongside the facility’s nurses and the attending physician. Start by telling us the facility’s name, or ask its nursing staff to contact Gateway. We confirm whether visits are available at that location and what the facility needs in order to begin.
What is the difference between a venous ulcer and an arterial ulcer?
Venous ulcers come from blood pooling in the leg. They tend to be shallow, wet and located near the ankle on a swollen leg. Arterial ulcers come from too little blood reaching the tissue and are often on the toes, foot or shin, with a dry base and pain that worsens when the leg is raised. Some people have both. Telling them apart takes a clinical exam and circulation testing.
Can I request primary care at home in Madison County if I do not have a wound?
Yes. Wound care and primary care can be arranged separately or together, depending on what the patient needs. A request can be for follow-up of ongoing conditions such as diabetes, heart disease or memory loss, or for follow-up after a hospital stay, with no wound involved. The treating clinician determines what care is appropriate, and availability is confirmed for your town 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.