What to know about venous leg ulcers
Leg veins have to push blood uphill. They rely on two helpers: one-way valves inside the vein, and the calf muscle, which squeezes the veins with every step. When valves wear out or are damaged by an old blood clot, blood slips backward and collects near the ankle. Pressure in those veins stays high whenever you sit or stand.
That pressure forces fluid and blood cells out into the tissue, which swells, stiffens and receives less oxygen and nourishment than healthy skin. Skin in that state is easy to injure and slow to mend. A scrape from a walker, an insect bite or scratching an itchy patch can be enough to start an ulcer.
What an assessment covers
The history shapes a venous ulcer plan as much as the exam does. The treating clinician asks how long the ulcer has been open, whether this leg has ulcerated before, and whether you have had a blood clot, a vein procedure, leg surgery or an injury. Allergies are reviewed, along with any skin reaction to past dressings, tapes or wraps, so the same products are not ordered again.
The clinician also asks what you have already tried and what happened. An ulcer that does not look or behave like a typical venous wound, or one that fails to respond, may lead to more tests or a referral to a vascular or skin specialist.
Arranging this care in Fairview Heights
People in Fairview Heights with venous leg ulcers sometimes see a vascular specialist in St. Louis and receive the rest of their care in Illinois. That split can leave gaps, such as test results from one side of the river never reaching the clinician who wraps the leg on the other. Gateway gathers the records, including circulation studies done before compression, and shares them with the treating clinician. When a trip across the river for specialty care is needed, we help with scheduling and transportation. Whether a Missouri-based provider can be used under an Illinois plan is checked first, not assumed.
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
When a home health agency is already visiting, its nurses commonly change dressings and reapply compression between the treating clinician’s visits. Gateway shares current orders with the agency so both work from the same plan, and we pass the nurses’ observations back. Supplies need the same attention. A draining venous ulcer can go through a large amount of absorbent dressings, padding and wrap layers in a week. We coordinate orders for the supplies the clinician specifies and check in before they run low. What a health plan pays for depends on the plan, the treating provider and the care needed.
In a facility
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.
Changes to report
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
A draining venous ulcer asks a lot of the body. Protein is lost in wound fluid, and healing skin needs steady calories, protein and fluids to rebuild. Older adults with a poor appetite, dental problems or a tight food budget can fall behind without anyone noticing. A primary care clinician can check weight trends and lab work, look for anemia, and review diabetes control, since high blood sugar slows repair and raises infection risk. Body weight matters as well, because extra weight adds pressure to leg veins. None of this replaces wound care. It supports it, which is why Gateway can arrange both.
Getting care arranged in Fairview Heights
To arrange venous leg ulcer care in Fairview Heights, call Gateway at 314-325-0126. Patients, family members and caregivers can call directly, and a referral is not required. We will ask where the patient lives, what has been done for the wound so far and which clinicians are involved. Gateway then confirms whether a partner clinician is available for that address and care setting, requests the relevant records and schedules the visit. At that visit the treating clinician examines the wound and decides on the plan. Our job from then on is the coordination: orders, supplies, follow-up visits and keeping the care team informed.
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 venous leg ulcers, or see everything Gateway arranges on the mobile wound care in Fairview Heights 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 O'Fallon
- Venous leg ulcer care in Belleville
- Venous leg ulcer care in Collinsville
- Venous leg ulcer care in St. Clair County
Common questions
Who arranges long-term compression garments for patients in Fairview Heights 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.
Should I walk or rest with a venous leg ulcer?
Usually some of each, as directed by your clinician. Walking and ankle movement work the calf muscle that pushes blood up the leg, while resting with the legs raised lets swelling drain. Long periods of standing still or sitting with the feet down tend to help least. Ask the treating clinician what balance is right for you, especially if you have heart, artery or balance problems.
Is it normal for a venous leg ulcer to hurt?
Many do, though the amount of pain varies widely. Aching and heaviness that ease with elevation are common. Pain at dressing changes can sometimes be reduced with a different dressing or approach, so mention it. Pain that suddenly gets worse, or pain with spreading redness, fever or cold, discolored toes, should be reported to the treating clinician promptly and not waited out.
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.