What to know about diabetic foot ulcers
The most common mistake with a diabetic foot ulcer is judging it by pain. A numb foot can carry a deep wound that feels like nothing at all. A second mistake is assuming a small opening means a small problem, when the damage under a callus can be wider than the hole in the skin. People also tend to think that keeping the wound covered is the whole treatment, yet a good dressing does little if the foot still bears weight on that spot all day. And many people believe an ulcer leads straight to amputation. It does not have to. Early attention, pressure relief and steady follow-up are what clinicians rely on to protect the foot.
What the treating clinician looks at
At the first visit the treating clinician usually measures the length, width and depth of the ulcer and notes what the base looks like: pink or red tissue, yellow slough, dark dead tissue, or structures that should not be visible. The edges get attention too, because a thick rim of callus or skin that has been undermined changes the plan. The amount, color and odor of any drainage are recorded. The clinician may also check whether the wound reaches toward bone, since that raises the question of bone infection and may lead to imaging or lab work. These findings become the baseline that later visits are measured against.
Arranging this care in Ladue
Many people in Ladue have lived in the same house for decades and intend to stay. A diabetic foot ulcer tests that plan. Older homes tend to have steps at every entrance, laundry in the basement and a tub to climb into, each one a moment of full weight on the wounded foot. During home visits the treating clinician can point out practical changes, and Gateway follows up on any equipment ordered. If care needs outgrow the house, skilled nursing and rehabilitation facilities are close by, and you can ask us about continuing wound visits there.
Clayton Road and Ladue Road carry most of the traffic through Ladue, a residential city in Mid County just west of Clayton. Away from those two roads, the streets turn into quiet lanes with large wooded lots and houses set well back from the curb. Interstate 64 and Interstate 170 are both close. There is little commercial development inside the city limits, so most medical appointments mean a drive to a neighboring city. For someone with a wound or limited mobility, care arranged at home removes that trip.
When care happens 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.
In a facility
In a skilled nursing facility, a diabetic foot ulcer is managed by several people at once. A partner clinician visits on site to assess the wound and write or recommend orders, the facility nurses carry out dressing changes and daily skin checks, and the attending physician oversees the resident’s overall care. Gateway keeps those lines connected. We schedule rounds with the facility, send visit notes for the chart and confirm that new orders were received and signed as the building requires. Offloading orders, such as heel protection in bed or a boot for transfers, go to the nursing and therapy staff who apply them every shift.
Changes to report
Whoever changes the dressing is well placed to spot trouble. Let the treating clinician know if you see any of the following:
- Drainage soaking through sooner than it used to
- The wound measuring larger, or new openings nearby
- Skin around the wound turning white, soggy or raw
- A new blister or rubbed area where the boot, cast or shoe touches
- Fresh blood on a dressing that used to come off clean
Bleeding that will not stop with firm pressure, sudden weakness, slurred speech or difficulty breathing are reasons to call 911, not to wait for a call back.
Primary care and overall health
The blood that reaches the foot is what feeds a healing ulcer, and the health of the arteries is largely a primary care matter. Blood pressure, cholesterol, kidney function and tobacco use all affect the vessels in the legs. A primary care clinician tracks these, orders the lab work and can coordinate referrals to vascular or kidney specialists when the wound clinician raises a concern. Leg swelling from heart or kidney conditions matters as well, because a swollen foot fits poorly in an offloading device. When Gateway arranges both kinds of care, findings from one visit can inform the other instead of sitting in separate charts.
Arranging diabetic foot ulcer care in Ladue
You may already have a surgeon, a wound clinic or a home health nurse and still want help with diabetic foot ulcer care closer to home in Ladue. 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.
After a hospital stay, people in Ladue most often come home from Missouri Baptist Medical Center in Town and Country, SSM Health St. Mary’s Hospital in Richmond Heights or Mercy Hospital St. Louis in Creve Coeur. All three are a short drive away, and none is affiliated with Gateway. Families can call us to ask about wound care or primary care follow-up once a discharge date is set. Hospital discharge planners can refer by phone or fax and include the discharge summary, wound orders and the name of the person who will be at the home.
- County: St. Louis County, Missouri
- ZIP codes: 63124
- Nearby hospitals: Missouri Baptist Medical Center in Town and Country; SSM Health St. Mary's Hospital in Richmond Heights; Mercy Hospital St. Louis in Creve Coeur (not affiliated with Gateway)
- Nearby communities: Clayton and Central County, Creve Coeur, Richmond Heights, Brentwood, University City
- Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation
Related care in Ladue
Read the full guide to diabetic foot ulcers, or see everything Gateway arranges on the mobile wound care in Ladue page.
- 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
- Wounds with lymphedema
- Skin graft aftercare
- Wound VAC (NPWT) follow-up
- Diabetic foot ulcer care in Clayton and Central County
- Diabetic foot ulcer care in Creve Coeur
- Diabetic foot ulcer care in University City
Common questions
My parent lives in a nursing home in Ladue. 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.
Will the clinician remove tissue from the wound during a visit?
Possibly. Removing callus and dead tissue, called debridement, is a common part of diabetic foot ulcer care, because unhealthy tissue hides the true size of the wound and can hold bacteria. Whether it is done, by what method and how often is up to the treating clinician, who considers blood flow first. Ask what to expect afterward, since a freshly cleaned wound can look larger.
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.
Can a private caregiver or household assistant call Gateway on behalf of someone in Ladue?
Yes. A caregiver, family member or assistant can make the first call for a patient in Ladue. We will ask for the patient’s name, address and phone number, and who should be the main contact for scheduling. If a home health agency or hired caregiver is already helping, tell us so the treating clinician knows who else is involved. The web form takes contact details only, so share medical information by phone.
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.