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 the treating clinician looks at

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 Granite City

People in Granite City 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 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.

Care 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

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 Granite City →

How to get started in Granite City

If you have been managing a wound mostly on your own and are looking for venous leg ulcer care in Granite City, 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.

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.

More wound care in Granite City

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

Common questions

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

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.

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.

Can a clinician come to a home in Granite City to care for a venous leg ulcer?

In many cases, yes. Gateway arranges visits from partner clinicians to private homes, and we confirm availability for your address and care setting when you call. The clinician assesses the leg, writes the orders and returns on the schedule they set. Call 314-325-0126 to ask. For anything life-threatening, call 911 instead.

My specialists are in St. Louis, but I live in Granite City. Can Gateway still arrange care at home?

Yes. Gateway works on both sides of the river, in Greater St. Louis and the Metro East. Give us the names of your specialists and we will coordinate records and orders with their offices so the treating clinician knows the existing plan. Whether a given insurance plan applies in your case depends on the treating provider, the plan and the care needed, and you can ask when you call.

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.