Venous leg ulcer care in Ladue.

What to know about venous leg ulcers

Healing rarely moves in a straight line with a venous leg ulcer. Early in care, drainage often changes before size does, and a leg that is less swollen is usually an encouraging sign. The wound may even look larger for a time as unhealthy tissue clears from its edges.

Progress can stall when swelling returns, when compression is off for long stretches, or when an infection or skin reaction sets in. Clinicians compare measurements from visit to visit and rethink the plan if the ulcer stops changing. After the skin closes, the vein problem is still there, so these ulcers are known for returning unless swelling stays controlled over the long term.

What an assessment covers

A plan for a venous leg ulcer has to work on ordinary days, so the treating clinician looks at how you live with the leg. Can you bend far enough to reach your foot? Do your hands have the grip to pull on a stocking? Who is in the house to help, and how often? What shoes fit over a wrap?

The answers guide the kind of compression that is ordered. Layered wraps applied by a clinician suit some people. An adjustable garment that a caregiver can manage suits others. A plan that fits your routine is more likely to stay on the leg, and compression only helps while it is worn.

Arranging this care in Ladue

Many people with venous leg ulcers in Ladue have lived in the same house for decades, and some later move to a senior living community or skilled nursing facility a short drive away. The ulcer plan should move with them. Gateway keeps track of the measurements, compression orders and supply details, so when someone goes from home to a rehabilitation stay and back, the receiving nurses know what was on the leg and why. Because partner clinicians see patients in both homes and facilities, the plan can often continue without starting the assessment over.

Most of Ladue is single-family homes, many of them large, on private lanes or at the end of long driveways. Some families have hired caregivers in the home. Apartments and senior living are less common in Ladue itself than in the cities around it, where many longtime residents move for assisted living, memory care or skilled nursing. Gateway arranges partner clinician visits in both places. For a home, we ask about gate codes, the easiest entrance and who will meet the clinician. For a facility, we work with the nursing staff on timing and orders.

When care happens at home

Family caregivers often carry part of the work for a venous leg ulcer at home. Depending on the orders, that might mean helping with a stocking or adjustable garment, changing an outer dressing, propping the legs at rest, or watching the toes and skin for changes. No one should have to guess. The treating clinician can show a caregiver which tasks are theirs and which to leave alone, and Gateway can request visit times when the caregiver is able to be there. If the caregiver works, travels or lives elsewhere, tell us, and with your permission we will keep them informed by phone.

For residents of nursing and senior living communities

In a skilled nursing facility, venous leg ulcer care is shared work. The partner clinician sees the resident on site, assesses the ulcer and the circulation, and writes or recommends orders in line with the facility’s process. Nursing staff carry out dressing changes and compression between visits and document what they see. Gateway keeps the two connected by scheduling rounds with the facility, sending visit notes and following up on open questions. The attending physician stays informed and remains in charge of the resident’s overall medical care, including the heart, kidney and medication issues that affect leg swelling.

What to report and when to call 911

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

Not all leg swelling comes from the veins. The heart, kidneys, liver and thyroid can each cause fluid to build up, and so can certain medicines for blood pressure, pain or diabetes. Sorting out which causes apply is primary care work, usually involving an exam, a medication review and sometimes blood tests or heart testing. That information changes wound care. A clinician planning compression wants to know, for example, whether heart failure is present and how stable it is. When Gateway arranges wound care and primary care together, findings move in both directions and the leg is not handled as if it were separate from the person.

Primary care at home in Ladue →

How to get started in Ladue

For a resident of a nursing home, assisted living or memory care community in Ladue, a request for venous leg ulcer care can come from the family, the resident or the facility’s nurses. Call 314-325-0126 and give us the facility name, the unit or room and the best nurse contact. Gateway speaks with the facility about its process for outside clinicians, confirms availability and coordinates a visit time that fits the resident’s day. After the visit, the treating clinician’s orders are given to facility nursing, and the family contact on file gets an update if the resident has agreed to that.

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

Other conditions and nearby communities

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

• Diabetic foot 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
• Venous leg ulcer care in Clayton and Central County
• Venous leg ulcer care in Creve Coeur
• Venous leg ulcer care in University City

Common questions