Understanding 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 the treating clinician looks at
A care plan for an arterial wound usually runs on two tracks. One protects the wound: dressings matched to how dry or moist it is, padding and footwear that keep pressure and friction off the area, and a close watch for infection. The other addresses the blood supply, which may mean a referral to a vascular specialist to see whether a procedure could open or bypass the narrowed artery.
The treating clinician sets the order of these steps. Until circulation is understood, the plan tends to be cautious, with an emphasis on keeping stable tissue stable instead of pushing for fast changes at the wound.
Arterial and mixed wound care in Ferguson
Many homes in Ferguson were built with the bedrooms upstairs, and people with arterial pain often end up sleeping in a recliner on the main floor with their feet down. That eases the ache but can bring swelling and leave a heel pressed against a footrest for hours. A treating clinician who visits the home can see the setup and adjust the plan for heel protection and positioning. Gateway arranges those visits for long-time residents who want to stay in the houses they know, and coordinates supplies so protective padding and dressings are delivered there.
In Ferguson you will see older frame and brick houses near the center of town, ranch homes in later subdivisions, and apartment complexes along the busier roads. Some households have three generations under one roof, and some older adults live alone. Skilled nursing, rehabilitation and assisted living facilities serve Ferguson and the neighboring cities. Gateway arranges partner clinician visits in homes, apartments and facilities alike. We ask who helps the patient day to day, because the treating clinician’s instructions need to reach that person, whether a daughter, a home aide or a charge nurse.
When care happens at home
When a home health agency is already visiting, its nurses and the wound care clinician need to work from the same orders. Gateway shares the treating clinician’s plan with the agency, so dressing changes between wound visits follow it and nobody applies a compression wrap that was not ordered.
Supplies are handled the same way. Once the clinician writes orders for dressings, padding or protective footwear, we coordinate the supply request and follow up on delivery to the home. If dressings are left over from an earlier leg wound, show them to the clinician before using them, because an arterial wound may call for something different.
In a facility
Many people arrive at a rehabilitation center after a hospital stay for a vascular procedure, an infection or a toe amputation, with a wound that still needs close follow-up. Therapy adds a complication: the foot has to bear weight and wear a shoe again.
The treating clinician works with facility nursing and therapists on how the wound is protected during sessions, and with the attending physician on orders. Gateway obtains the hospital’s operative and vascular reports, lines up any follow-up visit the surgeon requested, and plans how wound care will continue at home or in long-term care after discharge.
Signs to tell the clinician about
For a mixed wound, watch both the swelling and the circulation. Report these to the treating clinician:
- Swelling that rises quickly or spreads up the leg
- Toes that turn pale, blue or numb, or new pain, while a wrap or stocking is on
- Drainage soaking through dressings sooner than before
- New blisters or breaks in the skin near the wound
- Fever, chills or feeling unwell
Call 911 for a leg that suddenly becomes cold, white or blue and very painful, for chest pain or trouble breathing, or for signs of stroke such as a drooping face, weakness in one arm or slurred speech.
How primary care fits in
People with arterial or mixed wounds often take a long list of medications: for blood pressure, cholesterol, diabetes, heart rhythm, fluid and pain. Some affect swelling, some affect bleeding at the wound, and pain medicine may need review as the wound changes. Only the prescribing clinician should adjust any of them, which is one reason a current primary care relationship matters.
A primary care visit at home can include a full medication review. Gateway then sends the updated list to the wound care clinician and any vascular office involved, ahead of the next appointment or procedure.
Getting care arranged in Ferguson
To arrange arterial and mixed wound care in Ferguson, 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.
If you are arranging care for a relative in Ferguson, gather a few things first: the address in 63135, the phone number of whoever is home during the day, insurance cards, and the discharge folder if there was a hospital stay. Tell us if the patient uses a wheelchair or cannot answer the door. Ferguson is close to both interstates, so visits here fit well with others in Florissant, Hazelwood, Bridgeton, North St. Louis and the rest of North County. We confirm availability by location and care setting.
- County: St. Louis County, Missouri
- ZIP codes: 63135
- Nearby hospitals: Christian Hospital in North County; SSM Health DePaul Hospital in Bridgeton (not affiliated with Gateway)
- Nearby communities: Florissant, Hazelwood, North County, North St. Louis, Bridgeton
- Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation
More wound care in Ferguson
Read the full guide to arterial and mixed wounds, or see everything Gateway arranges on the mobile wound care in Ferguson page.
- Diabetic foot ulcers
- Venous leg ulcers
- Pressure injuries and bed sores
- 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
- Arterial and mixed wound care in Florissant
- Arterial and mixed wound care in Hazelwood
- Arterial and mixed wound care in North County
- Arterial and mixed wound care in North St. Louis
Common questions
Do I need a referral to ask about arterial wound care in Ferguson?
No. Patients, family members and caregivers in Ferguson can contact Gateway directly, and hospitals, facilities and physician offices can refer as well. Some health plans do require a referral or authorization before certain visits or tests, and the treating clinician may need earlier records. We explain what is needed for your situation after the first call, before a visit is scheduled.
What should I have ready before the first visit for an arterial or mixed wound?
Helpful items include a current medication list, the names of your primary care clinician and any vascular or heart specialists, and results of past circulation tests or leg procedures if you have them. Set out the shoes and slippers you wear most. Write down when the wound started and when pain is worst. Gateway can request outside records for the treating clinician, so missing paperwork is no reason to delay calling.
What is an ankle-brachial index, and does it hurt?
It is a common circulation test. Blood pressure cuffs are placed on the arms and ankles, and a small handheld ultrasound device listens to the pulse while each cuff is inflated. Comparing ankle and arm pressures shows whether blood flow to the foot is reduced. The cuff squeeze can be uncomfortable for a moment, especially near a sore area, so tell the person doing the test where your wound is.
Are visits arranged throughout the 63135 ZIP code in Ferguson, including apartments?
Requests are welcome from anywhere in 63135, whether the patient lives in a house, a duplex, an apartment complex or a care facility. For apartments, give us the complex name, building and unit number, and tell us how to reach the door. Gateway confirms visit availability for the specific address and setting. If we cannot arrange a visit there, we will say so directly.
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.