Understanding wounds with lymphedema
Lymphedema is long-term swelling that builds when the lymphatic system cannot carry fluid out of an arm or leg as fast as it collects. The lymphatic system is a network of thin vessels and nodes that returns fluid to the bloodstream and helps the body fight infection. When it falls behind, fluid that is rich in protein settles in the tissue under the skin.
A lymphedema wound is any open area on a limb swollen this way. It may be a shallow raw patch, a blister that has burst, a split at the bottom of a skin fold or a deeper ulcer. Most are on the lower legs, ankles and feet. What they share is the setting: skin that is stretched, damp and slow to repair itself.
How the care plan is built
Lymphedema wound care is built in stages, and the plan is expected to change. Early on, the focus is on reducing the swelling and controlling drainage, and wraps may need frequent adjustment as the limb shrinks and they loosen. At each visit the treating clinician measures the wound, and often the limb itself, and compares the numbers with earlier visits.
When the limb size has settled, attention turns to maintenance. That may mean fitting a garment for daily wear and deciding whether a lymphedema therapist should be involved. If the measurements stop improving, the clinician looks again at the cause, the fit of the compression and what is happening between visits.
Wound care with lymphedema in Kirkwood
Many people in Kirkwood have lived in the same house for decades and have managed swollen legs on their own for nearly as long, often with worn stockings and a routine that worked until the skin opened. Older homes add their own difficulties: a tub to step over when legs need washing, a bathroom up the stairs, a favorite chair with no way to raise the feet. A treating clinician visiting at home can see these and suggest workable changes. Gateway coordinates the visit and any garments or supplies ordered.
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
Supplies run out quickly when a lymphedema wound is draining. Absorbent dressings, padding and wrap materials may be changed several times a week, and going without them for even a day or two can set the limb back. Gateway coordinates supply orders with the treating clinician’s orders and follows up with the supplier on delivery to your home.
Tell us when you are getting low, well before the last box is opened. It also helps to mention practical problems, such as fluid soaking through to bedding or furniture, or dressings that will not stay in place overnight. The clinician can often change the dressing or the plan to deal with them.
Care in skilled nursing and assisted living
A resident with lymphedema usually has other conditions that the attending physician is managing, and several of them influence swelling. The treating wound clinician and the attending physician need the same information: what the wound looks like, what compression is in place, and whether fluid, weight or medicines have changed.
Gateway handles the paperwork side of that exchange. Visit findings and recommended orders go to the attending physician and the director of nursing, and relevant labs or notes from the facility come back to the wound clinician. Each clinician keeps authority over their own decisions, and the facility keeps one clear record.
Signs to tell the clinician about
Changes in the swelling itself can point to something beyond the wound. Tell the treating clinician about:
- Swelling that increases quickly over a day or two
- Swelling that moves higher, into the thigh, groin or belly
- Rapid weight gain, or shoes and garments that suddenly do not fit
- Needing extra pillows to breathe comfortably at night
Sudden swelling and pain in one leg, often with warmth in the calf, needs urgent medical evaluation because it may be a blood clot. Call 911 for chest pain, trouble breathing, coughing up blood, fainting, or a racing heartbeat with lightheadedness.
How primary care fits in
Lymph flow in the legs gets much of its push from the calf and foot muscles squeezing with each step, so anything that limits walking tends to worsen swelling. Primary care can look at what is holding a person back, whether that is joint pain, breathlessness, weakness or fear of falling, and whether therapy would help.
General health affects the wound as well. Healing draws on protein and calories, high blood sugar slows repair and raises infection risk, and extra body weight adds pressure on lymph vessels in the groin and legs. These are long-term concerns that a primary care clinician follows alongside the wound visits.
Arranging wound care with lymphedema in Kirkwood
You may already have a surgeon, a wound clinic or a home health nurse and still want help with wound care with lymphedema closer to home in Kirkwood. That is a fine reason to call 314-325-0126. Tell us who is treating the wound now and what is not working, whether that is the travel, the gaps between appointments or unclear instructions. Gateway does not replace your current clinicians. We can arrange for a partner clinician to see the wound where you live and, with your permission, share notes with the offices already involved so the plans agree.
People in Kirkwood are often discharged from St. Luke’s Des Peres Hospital, Missouri Baptist Medical Center in Town and Country, Mercy Hospital South or SSM Health St. Clare Hospital in Fenton. Gateway is not affiliated with these hospitals. If you are going home with a wound, a family member can call us before or after discharge to ask about follow-up. Discharge planners and case managers can send a referral by phone or fax with the discharge summary and current wound orders. We then confirm visit availability with a partner clinician for the Kirkwood address or facility.
- 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
More wound care in Kirkwood
Read the full guide to wounds with lymphedema, or see everything Gateway arranges on the mobile wound care in Kirkwood page.
- Diabetic foot ulcers
- Venous leg ulcers
- Pressure injuries and bed sores
- Arterial and mixed wounds
- Non-healing wounds
- Post-surgical wounds
- Reopened (dehisced) surgical wounds
- Surgical site infections
- Skin tears and traumatic wounds
- Skin graft aftercare
- Wound VAC (NPWT) follow-up
- Wound care with lymphedema in Webster Groves
Common questions
Do I need a referral to request lymphedema wound care in Kirkwood?
No. Patients, family members and caregivers can call Gateway directly at 314-325-0126 or send a callback request, with or without a referral. Some health plans have their own referral or authorization rules, and we ask about those when we confirm the treating provider. The web form asks only for a name and phone number, so please save medical details for the phone call.
Can I shower with a lymphedema wound and compression wraps?
Ask the treating clinician, because the answer depends on the dressing and the type of compression. Some wraps are meant to stay on and stay dry for several days, while others come off daily. Clean skin matters a great deal with lymphedema, so the clinician will explain how washing fits into your routine and how to protect anything that must not get wet.
Why do I keep getting cellulitis in the same leg?
A limb with lymphedema clears bacteria slowly, so germs that get in through a crack, a blister or peeling skin between the toes can take hold quickly. Each infection can scar more lymph vessels, which adds swelling and sets up the next one. Tell your clinicians how often it has happened. They can look for the entry points and decide what prevention makes sense for you.
My father is coming home to Kirkwood from St. Luke’s Des Peres Hospital. When should we call?
You can call as soon as you know the discharge plan, or after he is home. Tell us the hospital, the expected discharge date and his Kirkwood address. Gateway is not part of the hospital, so we will ask for the discharge paperwork and current wound orders. A partner clinician’s availability is then confirmed for his location. If something seems urgent, call his doctor, or 911 in an emergency.
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.