Diabetic foot ulcer care in Maryland Heights.

What to know about diabetic foot ulcers

A diabetic foot ulcer is an open wound on the foot of a person with diabetes, deep enough that the full thickness of the skin is gone. Common places are the ball of the foot, the tips and tops of the toes, the heel and the outer edge of the foot. It can look like a shallow crater ringed with thick callus, or like a small hole that runs deeper than its opening suggests. Clinicians describe an ulcer by its location, size and depth, the tissue in its base, and whether infection or poor blood flow is present. Those descriptions guide what gets ordered, and they give everyone involved a shared way to tell whether the wound is improving.

How the care plan is built

A care plan for a diabetic foot ulcer usually rests on a few parts that the treating clinician fits to the person. Pressure relief comes first, whether through a removable boot, a cast, a special shoe or limits on standing. Next is preparing the wound bed, which may mean removing callus and dead tissue during visits. A dressing is chosen to match the amount of drainage, and it may change as the wound does. Infection, if present, is addressed with the testing and treatment the clinician orders. Finally, the plan names who changes the dressings, how often visits happen, and what finding at follow-up would prompt a different approach.

Arranging this care in Maryland Heights

In Maryland Heights, a person with a foot ulcer is often a long-time homeowner whose spouse or neighbor helps out, and whose podiatrist and primary care doctor are close by. That existing circle is an asset. Gateway sends updates to each office after wound visits, so the people who know the patient are not working from old information. Seniors who have moved to an independent or assisted living community nearby can be seen there too. In either setting, show the clinician the worn house shoes by the door, because comfortable old footwear is a frequent source of rubbing.

Interstate 270 and Page Avenue cross in Maryland Heights, which puts this St. Louis County city within reach of most of the region. It runs from residential streets along Dorsett Road west to Creve Coeur Lake and the Missouri River bottoms. The city mixes subdivisions with office parks and a large number of apartment communities, so neighbors range from retirees in longtime family homes to renters who arrived recently. Both groups include people who cannot easily get to a clinic, and care arranged at home or in a facility fills that gap.

At home between visits

Most of the time a foot ulcer spends healing falls between visits, so the plan for those days matters. The treating clinician will spell out how often the dressing is changed, who changes it, how much walking is allowed and what goes on the foot indoors, including short trips to the bathroom at night. Keeping the offloading boot or shoe beside the bed makes those trips easier to do correctly. A simple daily routine helps: look at both feet, check whether drainage has soaked through the dressing, and write down anything new. If a question comes up, call Gateway and we will pass it to the treating clinician.

For residents of nursing and senior living communities

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.

What to report and when to call 911

Infection is the change clinicians most want to hear about early, and in a numb foot it may not hurt. Contact the treating clinician promptly if you notice:

• Redness that is spreading, or a red streak moving up the foot or leg
• Skin around the ulcer that feels warmer than the other foot
• Thicker, cloudy or foul-smelling drainage
• New swelling of the foot or ankle
• Fever, chills or feeling generally unwell

Call 911 for confusion, a racing heart, trouble breathing or fainting. Gateway is not an emergency service.

Why primary care matters here

Blood sugar and wound healing are closely tied. When glucose runs high over time, the cells that fight infection and rebuild tissue work less well, and an infected wound can in turn push readings higher. Wound visits do not manage diabetes medications. That belongs to the primary care clinician or endocrinologist, who may review recent readings, lab results and the current regimen while the ulcer is being cared for. Gateway helps the two sides share information, so the clinician managing diabetes knows there is an open wound and the wound clinician knows how glucose has been running.

Primary care at home in Maryland Heights →

Getting care arranged in Maryland Heights

If you have been managing a wound mostly on your own and are looking for diabetic foot ulcer care in Maryland Heights, you can call Gateway yourself at 314-325-0126. Tell us what the wound looks like now, what the last clinician said about it and what is getting harder to manage. It helps to know the patient’s insurance and the names of the doctors involved, but do not wait until you have everything. We check whether a partner clinician can see the patient at home or in their facility, and we tell you what we find. The treating clinician takes it from there, and you stay part of the conversation.

Three hospitals are close to Maryland Heights: Mercy Hospital St. Louis and Barnes-Jewish West County Hospital, both in Creve Coeur, and SSM Health DePaul Hospital in Bridgeton. Gateway is not affiliated with any of the three. Discharge planners can call or fax a referral for a patient returning to a Maryland Heights home, apartment or facility, and should include the discharge summary and any wound orders. Families can call too, with or without a referral. We contact a partner clinician, confirm availability for that address and tell you what happens next.

• County: St. Louis County, Missouri
• ZIP codes: 63043
• Nearby hospitals: Mercy Hospital St. Louis in Creve Coeur; Barnes-Jewish West County Hospital in Creve Coeur; SSM Health DePaul Hospital in Bridgeton (not affiliated with Gateway)
• Nearby communities: Creve Coeur, Bridgeton, Overland, Chesterfield and West County, Hazelwood
• Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Related care in Maryland Heights

Read the full guide to diabetic foot ulcers, or see everything Gateway arranges on the mobile wound care in Maryland Heights 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 Creve Coeur
• Diabetic foot ulcer care in Chesterfield and West County
• Diabetic foot ulcer care in Hazelwood

Common questions