About venous leg ulcers

Healing rarely moves in a straight line with a venous leg ulcer. Early in care, drainage often changes before size does, and a leg that is less swollen is usually an encouraging sign. The wound may even look larger for a time as unhealthy tissue clears from its edges.

Progress can stall when swelling returns, when compression is off for long stretches, or when an infection or skin reaction sets in. Clinicians compare measurements from visit to visit and rethink the plan if the ulcer stops changing. After the skin closes, the vein problem is still there, so these ulcers are known for returning unless swelling stays controlled over the long term.

What an assessment covers

Most care plans for a venous leg ulcer are built from the same parts, each set by the treating clinician for your leg:

  • Compression, if circulation allows it
  • A dressing schedule based on drainage
  • Cleansing and protection for the surrounding skin
  • Removal of unhealthy tissue when the clinician judges it necessary
  • Guidance on elevation, walking and ankle movement
  • A date to remeasure and review

The clinician writes the orders. Gateway then coordinates what the orders require: supplies, the visit schedule, and copies of the plan for home health, facility nursing or your primary care clinician. If the ulcer is not responding, the plan is reviewed and changed.

Venous leg ulcer care in Florissant

Many people with venous leg ulcers in Florissant have lived in the same house for decades, and some later move to a senior living community or skilled nursing facility a short drive away. The ulcer plan should move with them. Gateway keeps track of the measurements, compression orders and supply details, so when someone goes from home to a rehabilitation stay and back, the receiving nurses know what was on the leg and why. Because partner clinicians see patients in both homes and facilities, the plan can often continue without starting the assessment over.

Single-story ranch houses are the typical Florissant home, which helps patients who cannot manage stairs. The city also has garden apartments, condominiums, senior apartment communities, assisted living, and skilled nursing and rehabilitation centers. Gateway arranges partner clinician visits in every one of these settings. A request can come from a homeowner, a relative or a facility’s nursing office. We then match the visit to the setting: a time of day that suits a family caregiver at home, or a time that works with medication passes and therapy in a facility.

At home between visits

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.

For residents of nursing and senior living communities

Residents in memory care may not understand why a leg is wrapped. They may pull at the bandage, scratch the skin beneath it or be unable to say that it feels too tight. The treating clinician takes that into account when choosing dressings and compression, and may adjust the plan when a resident does not tolerate a wrap. Staff observations carry extra weight here. Restlessness, guarding the leg, a change in walking or a new refusal to wear shoes can all signal discomfort. Gateway shares the clinician’s instructions with the care team and keeps the family or legal representative updated on visits and changes.

What to report and when to call 911

Venous leg ulcers can become infected, and infection in the skin of the leg can spread. Report these changes to the treating clinician promptly:

  • Redness, warmth or swelling that is spreading beyond the ulcer
  • Pain that is getting worse instead of better
  • Thick, cloudy or foul-smelling drainage
  • Fever, chills or feeling generally unwell
  • An ulcer that is suddenly larger or deeper

Call 911 for chest pain, shortness of breath, confusion or fainting, or bleeding from the leg that does not stop with firm, steady pressure.

Why primary care matters here

The calf muscle acts as a pump for the leg veins, and it only works when the ankle moves. Arthritis, nerve damage, an old injury, pain from the ulcer itself or fear of falling can shrink a person’s walking to a few steps a day. A primary care clinician can look at what is limiting movement, manage pain, review fall risk and order physical therapy or equipment when appropriate. Sleep is part of this too. People who sleep upright in a recliner because of breathing trouble or back pain keep their legs down all night, and the reason behind that habit needs a medical answer.

Primary care at home in Florissant →

How to get started in Florissant

If you have been managing a wound mostly on your own and are looking for venous leg ulcer care in Florissant, you can call Gateway yourself at 314-325-0126. Tell us what the wound looks like now, what the last clinician said about it and what is getting harder to manage. It helps to know the patient’s insurance and the names of the doctors involved, but do not wait until you have everything. We check whether a partner clinician can see the patient at home or in their facility, and we tell you what we find. The treating clinician takes it from there, and you stay part of the conversation.

Florissant residents usually go to Christian Hospital in North County, east along Interstate 270, or to SSM Health DePaul Hospital in Bridgeton to the southwest. Gateway is independent of both. For discharge planners, the process is short: fax the referral, wound orders and face sheet, and note whether the patient is going home or to a facility. For families, call and tell us the hospital and the going-home date. Gateway requests the records, checks availability in 63031, 63033 or 63034, and arranges follow-up with a treating clinician.

  • County: St. Louis County, Missouri
  • ZIP codes: 63031, 63033, 63034
  • Nearby hospitals: Christian Hospital in North County; SSM Health DePaul Hospital in Bridgeton (not affiliated with Gateway)
  • Nearby communities: Hazelwood, Ferguson, North County, Bridgeton
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Related care in Florissant

Read the full guide to venous leg ulcers, or see everything Gateway arranges on the mobile wound care in Florissant page.

Common questions

Do I need a referral to start venous leg ulcer care in Florissant?

No referral is needed to call Gateway. Patients, family members and caregivers can contact us directly, and hospitals, facilities and practices can refer as well. Some health plans have their own referral or authorization rules, which depend on the plan and the treating provider. We will tell you what records or orders the treating clinician needs before a first visit.

Could a leg ulcer that will not heal be something other than a venous ulcer?

Yes. Poor arterial circulation, diabetes, pressure, inflammatory conditions, certain infections and, rarely, skin cancer can all cause leg wounds that resemble venous ulcers. That is one reason the clinician reassesses an ulcer that is not responding as expected. Further circulation testing, lab work, a tissue sample or a specialist referral may be ordered. Raise the question directly if you are worried.

Will Medicare or my insurance pay for compression supplies and visits?

You can ask us about Medicare, Medicare Advantage, Medicaid and commercial plans. What is paid for depends on the treating provider, your specific plan and the care that is needed, and rules for compression garments and dressings vary a good deal from plan to plan. Gateway helps confirm the details before care starts so you can decide with clear information.

My parents have lived in the same Florissant ranch house for decades and do not want to move. Can care come to them?

Yes. Helping people stay in their own home is what in-home care is for. A partner clinician can visit for wound care, primary care follow-up or both, and can see both parents if each needs care. Tell us about each person separately when you call. The treating clinician will say if a need goes beyond what can be managed at home.

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.