What to know about wounds with lymphedema
Wounds form on a limb with lymphedema because swollen tissue is fragile tissue. Fluid pushes skin cells farther from the small blood vessels that feed them, so oxygen and nutrients arrive slowly. The stretched surface tears easily, and a scratch from a pet, a bump against a bed frame or a rubbing shoe can open it.
Once the skin is open, lymph fluid seeps out. The steady moisture softens the surrounding skin until it turns white and breaks down, and the open area widens. Bacteria that would normally be carried away by lymph flow linger in the tissue. Each problem feeds the next, which is why treating clinicians usually address the swelling and the wound in the same plan.
What the treating clinician looks at
Compression is the main tool for reducing lymphedema, but it is not right for every limb on every day. Before ordering it, the treating clinician checks blood flow to the foot or hand, sometimes with a simple circulation test, because squeezing a limb with poor arterial supply can do harm. Heart and kidney conditions are reviewed, since moving fluid out of the legs places extra load on the heart. Loss of feeling in the feet also matters. A person who cannot feel a wrap digging in cannot report it.
With that information the clinician decides whether to use compression, what kind, and how firm. The decision is revisited as the limb changes.
Arranging this care in Fairview Heights
For people in Fairview Heights, lymphedema care often spans two states. Cancer treatment or vascular care may have happened at a St. Louis hospital, while primary care, home health and the health plan are based in Illinois. Records sit on both sides of the river. Gateway gathers them and confirms first which partner clinician can see you in Illinois. Illinois Medicaid and Missouri plans follow different rules, and benefits for compression garments, wraps and dressings vary, so coverage questions are raised before visits begin.
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.
At home between visits
Few people with lymphedema in the legs can manage the care alone. Reaching the feet, lifting a heavy limb and applying layers of wrap take flexibility and strength that the condition itself wears away. A spouse, an adult child or a paid caregiver often does the daily skin care, and the treating clinician may order home health nursing for dressing changes and compression.
Gateway shares the clinician’s orders with the home health agency and coordinates the schedule so everyone follows one plan. Caregivers are welcome at visits. It is the right time to ask what you are expected to do and what should be left to a nurse.
Care in skilled nursing and assisted living
Memory care and assisted living bring their own challenges for lymphedema. A resident with dementia may pull at a wrap, unroll it or be unable to say that it hurts, so staff need to know what to watch for: toes changing color, a wrap bunched behind the knee, fluid soaking through. The treating clinician takes this into account when choosing the type of compression.
Assisted living staff are often not permitted to change dressings or apply wraps. In that case the clinician may order home health nursing to come to the apartment, and Gateway coordinates among the agency, the community and the family.
Signs to tell the clinician about
Small changes in the skin of a limb with lymphedema are worth reporting early, while they are easier to deal with. Let the treating clinician know about:
- A wound that is getting larger or deeper
- A clear increase in leaking, or dressings that soak through faster than before
- New blisters, raw patches or cracks, especially in skin folds
- Skin around the wound that turns white, soggy or sore
- Itching, scaling or splits between the toes
- A new or stronger odor
Call 911 for heavy bleeding that does not stop with firm pressure, or if the person becomes confused or hard to wake.
How primary care fits in
Because lymphedema lasts longer than any single wound, someone needs to hold the long view. A primary care clinician can track how often skin infections return, check the feet and toenails for the fungal problems that let bacteria in, and serve as the point of contact for the other specialists you see.
Gateway arranges wound care and primary care together for this reason. When the wound visits wind down, there is already a clinician who knows the history, the garments in use and what an early flare looks like for you. Questions such as who reorders garments, and how often the limb should be rechecked, have a place to go.
Getting care arranged in Fairview Heights
For a resident of a nursing home, assisted living or memory care community in Fairview Heights, a request for wound care with lymphedema can come from the family, the resident or the facility’s nurses. Call 314-325-0126 and give us the facility name, the unit or room and the best nurse contact. Gateway speaks with the facility about its process for outside clinicians, confirms availability and coordinates a visit time that fits the resident’s day. After the visit, the treating clinician’s orders are given to facility nursing, and the family contact on file gets an update if the resident has agreed to that.
People in Fairview Heights have three hospitals within a short drive: HSHS St. Elizabeth’s Hospital in O’Fallon, Illinois, Memorial Hospital Shiloh and Memorial Hospital Belleville. Gateway has no affiliation with them. If you are a family member, you can call while your relative is still admitted and tell us the planned discharge date and destination. If you are a discharge planner, a phone call or fax starts the referral. From there, Gateway requests the discharge instructions, shares them with the treating clinician and arranges follow-up for wound care, primary care or both.
- 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
Other conditions and nearby communities
Read the full guide to wounds with lymphedema, or see everything Gateway arranges on the mobile wound care in Fairview Heights page.
- Diabetic foot ulcers
- Venous leg 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
- Skin graft aftercare
- Wound VAC (NPWT) follow-up
- Wound care with lymphedema in O'Fallon
- Wound care with lymphedema in Belleville
- Wound care with lymphedema in Collinsville
- Wound care with lymphedema in St. Clair County
Common questions
Will Medicare or my health plan pay for lymphedema wound care in Fairview Heights?
It depends. You can ask us about Medicare, Medicare Advantage, Medicaid and commercial plans. Whether a provider participates, and what your benefits are, depends on the treating provider, your plan and the care the clinician orders. Visits, dressings, compression garments and pumps are often handled under different rules. We go over these questions with you before care starts.
Do I need a referral to request lymphedema wound care in Fairview Heights?
No. Patients, family members and caregivers can call Gateway directly at 314-325-0126 or send a callback request, with or without a referral. Some health plans have their own referral or authorization rules, and we ask about those when we confirm the treating provider. The web form asks only for a name and phone number, so please save medical details for the phone call.
Why does the skin on my swollen leg look thick and bumpy?
When protein-rich lymph fluid sits in the tissue for months or years, the skin responds by thickening and hardening. It may form deep creases at the ankle or grow small wart-like bumps, especially on the feet and toes. These changes are a sign of long-standing lymphedema. They make skin harder to keep clean and more likely to crack, so point them out to the treating clinician.
I came home to Fairview Heights from the hospital with wound care instructions. What does Gateway do with them?
We ask for a copy of the discharge instructions and any orders, and pass them to the treating clinician before the visit. The clinician assesses the wound, reviews the hospital’s plan and decides whether to continue or change it. Until then, follow the instructions you were given and call the hospital or your doctor with questions. Report increasing pain, redness, swelling, drainage or fever promptly.
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.