What to know about arterial and mixed wounds

Arterial and mixed wounds mostly affect older adults whose blood vessels have been under strain for decades. The people clinicians see most often include those who smoke or used to, people with diabetes, and people with high blood pressure, high cholesterol or chronic kidney disease, including those on dialysis. Many have already had a heart attack, a stroke, or a stent or bypass in a leg. Calf cramping that comes on with walking and eases with rest is a common earlier clue.

Mixed wounds tend to appear in people with a long history of leg swelling, varicose veins or a past venous ulcer who later develop artery disease on top of it.

What an assessment covers

Beyond the wound itself, the treating clinician gathers the history that explains it. Expect questions about:

  • How the wound started and how long it has been open
  • Pain: where, when, and what eases it
  • How far you can walk before your calves or feet hurt
  • Tobacco use, diabetes and past heart or vascular procedures
  • Shoes, slippers and whether you sleep in a bed or a recliner

The answers feed a plan with clear goals. For some people the aim is closure once circulation improves. For others, particularly when a procedure is not an option, the aim is comfort, protection and preventing infection.

Local context: Fairview Heights

Families in Fairview Heights sometimes assume a Missouri specialist is the only option for a wound caused by artery disease, or that a plan that works in one state works the same way in the other. Neither is safe to assume. Illinois Medicaid and Missouri plans differ, and vascular testing, procedures and wound visits may each be handled differently. Gateway starts by confirming which partner clinician can see you at your address and what your plan requires, such as a referral or prior authorization. If specialty care does mean crossing the river, we help arrange the appointment, records and transportation.

Much of Fairview Heights is made up of ranch and split-level houses in established subdivisions, with apartment and condominium complexes near the main roads. Senior apartments, assisted living and nursing care are found in and around the city as well. Gateway arranges visits with partner clinicians in any of these places. For an apartment, we ask about building entry and parking so the visiting clinician can reach the door. For a facility, we coordinate with the nurse on duty about timing and the resident’s records.

When care happens at home

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.

In a facility

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.

Changes to report

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

Healing draws on the whole body. High blood sugar damages small vessels and weakens the response to infection. Kidney disease, anemia and a poor appetite each limit what reaches the wound. A primary care clinician can check labs, review how well diabetes is controlled, and look at whether you are eating enough protein and calories to rebuild tissue.

When wound care and primary care are arranged together, a wound that stalls prompts a wider look at health and not only a change of dressing. Findings from either visit reach the other clinician through Gateway’s coordination.

Primary care at home in Fairview Heights →

Arranging arterial and mixed wound care in Fairview Heights

You may already have a surgeon, a wound clinic or a home health nurse and still want help with arterial and mixed wound care closer to home in Fairview Heights. 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.

For a Fairview Heights request, it helps to have the street address and unit number, the ZIP code (62208), any gate or entry instructions, the patient’s insurance card and a list of current medications. Gateway also arranges care in O’Fallon, Belleville, Collinsville and the rest of St. Clair County, which is useful when family members live in different towns. Scheduling depends on the care setting and location, and we confirm availability before setting a visit.

  • County: St. Clair County, Illinois
  • ZIP codes: 62208
  • Nearby hospitals: HSHS St. Elizabeth's Hospital in O'Fallon, Illinois; Memorial Hospital Belleville; Memorial Hospital Shiloh (not affiliated with Gateway)
  • Nearby communities: O'Fallon, Illinois, Belleville, Illinois, Collinsville, St. Clair County, Illinois
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Related care in Fairview Heights

Read the full guide to arterial and mixed wounds, or see everything Gateway arranges on the mobile wound care in Fairview Heights page.

Common questions

My father lives in a nursing facility in Fairview Heights. Can his arterial wound be seen there?

Partner clinicians see residents in skilled nursing, assisted living, memory care and rehabilitation settings, working with the attending physician and nursing staff. Whether visits are available at a particular facility in Fairview Heights is confirmed first. A family member can call Gateway, or the facility’s nursing team can send a referral. With permission from the resident or their representative, we keep the family contact updated.

Should I keep my legs up or down with an arterial or mixed wound?

It depends on your circulation, so this is a question for the treating clinician. Raising the legs helps vein-related swelling but can increase pain when arterial flow is low. Letting the legs hang can ease arterial pain but adds swelling. With a mixed wound, both effects are in play. The clinician can suggest positions for sitting and sleeping based on your test results and symptoms.

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.

I no longer drive. Can Gateway help me get from Fairview Heights to an outpatient appointment?

Gateway can help with transportation arrangements when the treating clinician recommends a visit in an outpatient or office setting, such as a test or a specialist appointment. Tell us about any mobility needs, such as a wheelchair or help with steps. What is available depends on your location, your plan and the type of appointment, so we go over the details with you beforehand.

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.