About arterial and mixed wounds
Over weeks and months, an arterial wound tends to change slowly instead of shrinking steadily the way a wound with a good blood supply does. It may stay the same size, deepen a little, or form a dry, dark cap. Pain often rises and falls with position and time of day.
What happens next usually depends on circulation. If a vascular specialist is able to improve flow, the wound may begin to respond. If not, the goal may shift to keeping it stable, comfortable and free of infection. Mixed wounds add swings in swelling and drainage. Setbacks commonly follow a new bump, a shoe that rubs or a stretch of illness.
What an assessment covers
Mixed wounds ask the treating clinician to balance two problems that pull in opposite directions. Vein disease calls for controlling swelling, usually with compression. Artery disease limits how much squeeze the leg can safely take. The clinician weighs the circulation results, the amount of swelling and drainage, and how the leg feels to the patient, then decides whether compression is appropriate and in what form.
The plan also covers care for the fragile, often discolored skin of the lower leg and dressings that can handle drainage. Orders are revisited as the leg changes, particularly after any vascular procedure.
Local context: Kirkwood
Many homes in Kirkwood 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.
Housing in Kirkwood covers a wide range. There are century-old frame houses with deep front porches, brick bungalows, mid-century ranch homes, and condominiums and apartments close to downtown. The city also has senior apartments, assisted living, memory care and skilled nursing communities. Gateway arranges visits by partner clinicians in each of these settings. For a private home, we confirm the address, the entry steps and who will be there. For a facility resident, we coordinate with the nursing staff so the treating clinician’s orders and visit notes reach the people providing daily care.
Care at home
Between visits, most of the daily work falls to you or a caregiver, guided by the clinician’s written instructions. That usually means looking at both feet every day, including between the toes and the backs of the heels, keeping the dressing as ordered, and wearing the footwear or heel protection the clinician recommended.
Gateway stays involved during these stretches. If something changes, a call to 314-325-0126 gets the message to the treating clinician’s team. If a vascular appointment is coming up, we confirm the date, the records and the ride so the trip is not wasted.
Care in skilled nursing and assisted living
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.
What to report and when to call 911
Arterial wounds can change quietly, so small differences are worth a call. Contact the treating clinician’s team promptly if you notice:
- Pain that is stronger, or that now wakes you at night
- A toe or patch of skin turning dusky, purple or black
- The wound getting wider or deeper
- New drainage or odor, or a dry scab turning soft
- Redness or warmth spreading out from the wound
Call 911 if a foot or leg suddenly turns cold, pale or blue, goes numb, or becomes severely painful or hard to move. A sudden loss of blood flow is an emergency.
Why primary care matters here
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.
Arranging arterial and mixed wound care in Kirkwood
Clinicians and facility staff referring a patient for arterial and mixed wound care in Kirkwood can call 314-325-0126 or fax 314-786-7966. Helpful to include: demographics and insurance, the working diagnosis, recent wound notes and measurements, current orders, the medication list and relevant test results. Please also tell us who should receive the treating clinician’s notes afterward. The online referral form takes contact details only, so clinical records should come by fax, not through the form. Gateway confirms that the referral arrived, checks availability for the patient’s address and lets your office know what has been scheduled.
Before you call 314-325-0126, it helps to have the patient’s name, the Kirkwood address or facility name, a phone number and the name of the regular doctor. If there was a recent hospital or rehab stay, tell us where it was and when it ended. Gateway also arranges care in nearby Webster Groves, Des Peres, Crestwood, Sunset Hills, Manchester and Valley Park, so relatives in two nearby towns can be discussed in one call. Visit days are confirmed for each address once a partner clinician is identified.
- County: St. Louis County, Missouri
- ZIP codes: 63122
- Nearby hospitals: St. Luke's Des Peres Hospital; Missouri Baptist Medical Center in Town and Country; Mercy Hospital South; SSM Health St. Clare Hospital in Fenton (not affiliated with Gateway)
- Nearby communities: Webster Groves, Des Peres, Crestwood, Sunset Hills, Manchester, Valley Park
- 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 Kirkwood 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 Webster Groves
Common questions
My father lives in a nursing facility in Kirkwood. Can his arterial wound be seen there?
Partner clinicians see residents in skilled nursing, assisted living, memory care and rehabilitation settings, working with the attending physician and nursing staff. Whether visits are available at a particular facility in Kirkwood is confirmed first. A family member can call Gateway, or the facility’s nursing team can send a referral. With permission from the resident or their representative, we keep the family contact updated.
Is walking good or bad when I have a foot wound from poor circulation?
Walking is commonly recommended for artery disease in general, but an open wound on the foot changes the picture. Pressure and rubbing can hold a wound back, and the right shoe or protective device matters. Ask the treating clinician how much to walk, what to wear on the foot and whether any part of it should be kept free of weight. The answer is individual.
Will Medicare or my insurance cover arterial wound care and circulation testing?
You can ask us about Medicare, Medicare Advantage, Medicaid and commercial plans. Whether a visit, test or supply is a covered benefit depends on the treating provider, your specific plan and the care the clinician orders, so we cannot tell you in advance that something is a covered benefit. Have your insurance card handy when you call. We will explain what the treating provider’s office needs and what to ask your plan.
Are stairs in the older homes in Kirkwood a problem for home visits?
Usually not. Many houses in Kirkwood have porch steps, narrow doorways or bedrooms upstairs. When you call, tell us where the patient spends most of the day and whether they can get to a first-floor room. That helps the treating clinician plan the visit. If equipment or supplies are ordered, Gateway coordinates getting them to the 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.