Understanding wounds with lymphedema

Over weeks and months, a lymphedema wound tends to follow the swelling. When the limb is well controlled, drainage usually slows, the edges firm up and the open area gets smaller. When compression lapses, an infection sets in or the person spends long days sitting, the limb fills again and the wound can stall or reopen.

Because of this, progress is rarely a straight line. Setbacks are common and do not mean the plan has failed, but they should be reported. In time, the goal shifts from closing the wound to keeping the skin intact, with garments and skin care that continue for the long term. The treating clinician sets expectations for your situation. No one can promise a timeline.

How the care plan is built

During the exam, the treating clinician looks at the wound and at all of the skin on the limb, since the next problem often starts a few inches from the current one. Typical points of attention include:

  • Where the wound sits, its size and depth, and what the wound bed looks like
  • How much it drains and what the fluid looks like
  • Skin folds, including the base of each fold
  • The spaces between the toes, where cracks and fungal infections hide
  • Warmth, redness or tenderness that could mean infection

These findings guide the choice of dressing, how often it is changed, and whether an infection has to be dealt with before anything else.

Wound care with lymphedema in Lake St. Louis

In many households in Lake St. Louis, the family member who helps with wraps leaves early for work and gets home late. That leaves a long stretch when a wrap that slips or a dressing that soaks through has no one to fix it. Tell the treating clinician about the household schedule. Orders can sometimes be built around it, and home health nursing during the day may be an option. If your relative lives in one of the newer senior living communities, Gateway coordinates with the staff there as well.

Homes here include lakefront houses with walkout lower levels, villas and condominiums built for easier upkeep, and newer subdivisions toward the edges of the city. Sloped lots and stairs are common, which matters when someone uses a walker or wheelchair. Lake St. Louis also has assisted living, memory care and skilled nursing communities. Gateway arranges partner clinician visits in all of these settings. We ask which entrance has the fewest steps and, for facilities, which nurse should receive the treating clinician’s orders after the visit.

Care at home

Few people with lymphedema in the legs can manage the care alone. Reaching the feet, lifting a heavy limb and applying layers of wrap take flexibility and strength that the condition itself wears away. A spouse, an adult child or a paid caregiver often does the daily skin care, and the treating clinician may order home health nursing for dressing changes and compression.

Gateway shares the clinician’s orders with the home health agency and coordinates the schedule so everyone follows one plan. Caregivers are welcome at visits. It is the right time to ask what you are expected to do and what should be left to a nurse.

For residents of nursing and senior living communities

Memory care and assisted living bring their own challenges for lymphedema. A resident with dementia may pull at a wrap, unroll it or be unable to say that it hurts, so staff need to know what to watch for: toes changing color, a wrap bunched behind the knee, fluid soaking through. The treating clinician takes this into account when choosing the type of compression.

Assisted living staff are often not permitted to change dressings or apply wraps. In that case the clinician may order home health nursing to come to the apartment, and Gateway coordinates among the agency, the community and the family.

Changes to report

Compression should feel snug and supportive. It should not hurt. Report these problems to the treating clinician, and ask ahead of time what to do if one of them shows up at night or on a weekend:

  • Numbness, tingling or a pins-and-needles feeling below the wrap
  • Toes or fingers that look pale, blue or dusky, or feel cold
  • Pain that builds under the wrap instead of easing
  • A wrap that has slid down, bunched up or formed a tight band
  • Fluid soaking through the outer layer

Call 911 for chest pain, sudden shortness of breath, or a foot or hand that turns cold, white and severely painful.

Why primary care matters here

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.

Primary care at home in Lake St. Louis →

Arranging wound care with lymphedema in Lake St. Louis

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 Lake St. Louis. 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.

SSM Health St. Joseph Hospital in Lake Saint Louis is the closest hospital for most residents, and Progress West Hospital in O’Fallon is a short drive east. Neither is affiliated with Gateway. When a patient is being discharged with a surgical wound, a pressure injury or a leg ulcer, the family or the hospital case manager can contact us to ask about follow-up at the Lake St. Louis address. A fax to 314-786-7966 with the discharge summary and wound orders gives the treating clinician what is needed to plan a first visit.

  • County: St. Charles County, Missouri
  • ZIP codes: 63367
  • Nearby hospitals: SSM Health St. Joseph Hospital in Lake Saint Louis; Progress West Hospital in O'Fallon (not affiliated with Gateway)
  • Nearby communities: Wentzville, O'Fallon, Missouri, Dardenne Prairie, St. Charles County
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Other conditions and nearby communities

Read the full guide to wounds with lymphedema, or see everything Gateway arranges on the mobile wound care in Lake St. Louis page.

Common questions

Will Medicare or my health plan pay for lymphedema wound care in Lake St. Louis?

It depends. You can ask us about Medicare, Medicare Advantage, Medicaid and commercial plans. Whether a provider participates, and what your benefits are, depends on the treating provider, your plan and the care the clinician orders. Visits, dressings, compression garments and pumps are often handled under different rules. We go over these questions with you before care starts.

My arm is swollen after breast cancer treatment and the skin has opened. Can Gateway help?

You can ask us about any lymphedema wound, including one on an arm or hand. Arm lymphedema after lymph node surgery or radiation carries the same infection risk as leg lymphedema, and a new opening in the skin should be reported promptly. Let your oncology team know as well. Gateway can arrange an assessment with a partner clinician and share the findings with the clinicians who managed your cancer care.

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.

My parents live in Lake St. Louis and I live out of state. Can I set up care for them?

Yes. Adult children often make the first call. Give us your parents’ names, their Lake St. Louis address and phone number, and tell us who should get updates. With your parents’ permission, Gateway can keep you informed about visit dates and what the treating clinician orders. The web form takes contact details only, so share health 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.