About diabetic foot ulcers

A diabetic foot ulcer is an open wound on the foot of a person with diabetes, deep enough that the full thickness of the skin is gone. Common places are the ball of the foot, the tips and tops of the toes, the heel and the outer edge of the foot. It can look like a shallow crater ringed with thick callus, or like a small hole that runs deeper than its opening suggests. Clinicians describe an ulcer by its location, size and depth, the tissue in its base, and whether infection or poor blood flow is present. Those descriptions guide what gets ordered, and they give everyone involved a shared way to tell whether the wound is improving.

What an assessment covers

A care plan for a diabetic foot ulcer usually rests on a few parts that the treating clinician fits to the person. Pressure relief comes first, whether through a removable boot, a cast, a special shoe or limits on standing. Next is preparing the wound bed, which may mean removing callus and dead tissue during visits. A dressing is chosen to match the amount of drainage, and it may change as the wound does. Infection, if present, is addressed with the testing and treatment the clinician orders. Finally, the plan names who changes the dressings, how often visits happen, and what finding at follow-up would prompt a different approach.

Arranging this care in Granite City

On the Illinois side of the river, foot ulcer care starts with questions about paperwork. A person in Granite City may have Illinois Medicaid, a Medicare Advantage plan built around Illinois hospitals, or an employer plan based in Missouri, and each can treat wound visits, offloading devices and dressings differently. Gateway confirms which partner clinician can see you and asks about benefits before scheduling, so an ordered boot or supply shipment is less likely to be held up later. Coverage depends on the treating provider, your plan and the care needed, and we will tell you what we learn.

Directly across the Mississippi from north St. Louis, Granite City spreads over the flat river bottom of Madison County. It grew up around steelmaking, and its neighborhoods show it: close-set houses on a street grid and families who have been here for generations. Illinois Route 3 runs through town, Interstate 270 passes to the north and the McKinley Bridge is a short drive south. For residents who are older, live alone or no longer drive, getting to a clinic on either side of the river is difficult. Care arranged at home or in a facility comes to them instead.

Care at home

A home visit for a diabetic foot ulcer shows the treating clinician things a clinic never does: the slippers by the bed, the step down into the garage, the route to the bathroom at night. During the visit the clinician examines the wound, provides the care that is needed and updates the orders. Gateway schedules the visit, confirms the address and how to get in, and sends records ahead so the clinician arrives informed. Afterward we follow up on whatever was ordered, such as a boot, dressing supplies or a test, so those items are not left waiting on a phone call.

For residents of nursing and senior living communities

Assisted living poses a particular challenge for diabetic foot ulcers. Residents are fairly independent, staff may not be permitted to change wound dressings, and a person can walk on a sore foot for days before anyone sees it. When Gateway arranges visits in an assisted living community, we ask who handles dressings between visits: facility staff, a home health nurse or family. The treating clinician shapes the plan around that answer. We also let the community’s nurse or wellness director know what to watch for, such as drainage on socks or a resident who has stopped wearing the prescribed shoe.

What to report and when to call 911

Some changes point to trouble with blood flow or to tissue that is dying. Report these to the treating clinician without waiting for the next visit:

  • Black, gray or dark purple skin on a toe, the heel or the wound edge
  • A wound that looks deeper, or one where bone or tendon can be seen
  • A toe that has become cold or discolored
  • Foot pain at rest or at night that eases when the leg hangs down

Call 911 if a foot or leg suddenly turns cold, pale or blue, or for chest pain, severe bleeding or loss of consciousness.

How primary care fits in

Healing an ulcer takes protein, calories and fluids, and that can pull against an eating plan built around blood sugar or kidney disease. Sorting out what to eat while a wound is open is a question for the primary care clinician or a dietitian. Medications deserve the same review. Some can affect swelling, blood sugar or healing, and only the prescribing clinician should adjust them. Arranging wound care and primary care together means these questions are asked by someone with the full medication list and recent lab results in hand, not saved for an appointment that is months away.

Primary care at home in Granite City →

Getting care arranged in Granite City

People asking about diabetic foot ulcer care in Granite City usually want to know what the first visit involves. Before it, Gateway collects the records the treating clinician asks for and confirms the time and place with you. During it, the clinician looks at the wound and the skin around it, measures it, asks about your health and medications and explains what they recommend. Afterward, the orders go to whoever does the daily care, supplies are requested and a follow-up is planned. Our guide to how mobile wound care visits work has more. To begin, call 314-325-0126. Whether a visit can be arranged is confirmed for your location.

Gateway Regional Medical Center in Granite City is the local hospital, and Anderson Hospital in Maryville is a drive to the east. Despite the similar name, Gateway Wound Care is a separate company and is not affiliated with either hospital. After a stay at one of them, or at a hospital in St. Louis, a relative or a discharge planner can ask us to arrange follow-up. We request the discharge orders, find out whether the patient is going home or to a facility, and set up a visit with a partner clinician once availability for that location is confirmed.

Related care in Granite City

Read the full guide to diabetic foot ulcers, or see everything Gateway arranges on the mobile wound care in Granite City page.

Common questions

My parent lives in a nursing home in Granite City. Can Gateway arrange foot ulcer visits there?

You can ask, and we will confirm availability for that building. Partner clinicians see residents in skilled nursing, assisted living, memory care and rehabilitation settings. A facility has its own attending physician and nursing staff, so we coordinate with them before scheduling. Call us, or ask the director of nursing to send a referral. Updates go to family when the resident or legal representative agrees.

What shoes should I wear once the ulcer has closed?

Footwear after closure is a medical decision more than a shopping one. Many people are measured for shoes and inserts made for diabetic feet, usually through a podiatrist or a footwear specialist on a clinician’s order. Going back to the shoes worn before the ulcer is a common reason wounds return. Ask the treating clinician when and how to move out of the offloading device.

What should I have ready for the first visit?

Gather a current medication list, recent blood sugar readings if you keep them, and any hospital or clinic papers about the foot. Set out the shoes, inserts, boot or other devices you use, along with the dressing supplies you have on hand. Write down the names of your doctors and your questions. A chair with good light and a place to prop the foot make the exam easier.

Is Gateway Wound Care part of Gateway Regional Medical Center in Granite City?

No. The names are similar, but Gateway Wound Care is a separate company and is not affiliated with Gateway Regional Medical Center. Gateway Wound Care arranges wound care and primary care with partner clinicians in homes and facilities, and it is not a hospital. If you are trying to reach the hospital, use the hospital’s own phone number. To ask about wound care or primary care visits, call Gateway Wound Care at 314-325-0126.

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.