Arterial and mixed wound care in Granite City.

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.

How the care plan is built

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.

Local context: Granite City

On the Illinois side of the river, arterial wound care in Granite City often involves both states. A circulation test may be done at an Illinois hospital while the vascular surgeon practices in St. Louis and the wound visits happen at home. Each piece can fall under different rules depending on whether you have Illinois Medicaid, Medicare, a Medicare Advantage plan or commercial coverage. That is why Gateway confirms the treating provider first and explains what to ask your plan, then keeps records moving between the Illinois and Missouri offices involved.

Much of Granite City is made up of modest frame and brick houses on small lots, some with steps up to the front door. Apartments, senior housing, assisted living, and skilled nursing and rehabilitation facilities are found in the area too. Gateway arranges visits in all of these settings with partner clinicians. If steps, a narrow doorway or a second-floor unit make leaving home hard, say so when you call, because that is the situation home visits are meant for. In facilities, we coordinate with staff about the visit time, the resident’s chart and current orders.

At home between visits

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.

Changes to report

A daily look at both feet catches many problems early. Tell the treating clinician about:

• A new sore, blister or dark spot on a toe, heel or ankle
• One foot that feels noticeably cooler than the other
• Foot pain when lying flat that eases when you hang the foot over the edge of the bed
• Skin around the wound turning red, shiny or tight
• A dressing with a new smell or a new color of drainage

Do not wait for the next scheduled visit to mention these. Call 911 if the foot or leg abruptly goes cold, numb and discolored, or if you cannot move it.

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.

Primary care at home in Granite City →

Arranging arterial and mixed wound care in Granite City

To arrange arterial and mixed wound care in Granite City, 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.

Calling about care in Granite City? Have the address and ZIP code (62040), a working phone number, a list of medications and the names of any doctors or specialists, including those across the river in Missouri. Gateway also arranges care in Collinsville, Edwardsville, Glen Carbon, Alton and the Riverbend, and elsewhere in Madison County. Scheduling depends on the care setting and where in the area the patient lives, so we confirm availability before a visit is set.

• County: Madison County, Illinois
• ZIP codes: 62040
• Nearby hospitals: Gateway Regional Medical Center in Granite City; Anderson Hospital in Maryville (not affiliated with Gateway)
• Nearby communities: Collinsville, Edwardsville, Glen Carbon, Alton and the Riverbend, Madison County, Illinois
• Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Other conditions and nearby communities

Read the full guide to arterial and mixed wounds, or see everything Gateway arranges on the mobile wound care in Granite City 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 Collinsville
• Arterial and mixed wound care in Edwardsville
• Arterial and mixed wound care in Glen Carbon
• Arterial and mixed wound care in the Riverbend

Common questions