Arterial and mixed wound care in Mehlville.

Understanding arterial and mixed wounds

An arterial ulcer is an open sore that develops because the arteries feeding the leg or foot have narrowed and can no longer carry enough blood to keep skin alive and repair it. Clinicians also call these ischemic wounds. They show up most on the tips of the toes, between the toes, on the heel, over the ankle bone and along the shin, places far from the heart or pressed on by shoes. The sore is often small, deep and dry, with a clean border. A mixed wound, sometimes called a mixed arterial-venous ulcer, sits on a leg where the veins are also failing, so swelling and drainage appear alongside the signs of a poor arterial supply.

How the care plan is built

Beyond the wound itself, the treating clinician gathers the history that explains it. Expect questions about:

• How the wound started and how long it has been open
• Pain: where, when, and what eases it
• How far you can walk before your calves or feet hurt
• Tobacco use, diabetes and past heart or vascular procedures
• Shoes, slippers and whether you sleep in a bed or a recliner

The answers feed a plan with clear goals. For some people the aim is closure once circulation improves. For others, particularly when a procedure is not an option, the aim is comfort, protection and preventing infection.

Local context: Mehlville

Many homes in Mehlville were built with the bedrooms upstairs, and people with arterial pain often end up sleeping in a recliner on the main floor with their feet down. That eases the ache but can bring swelling and leave a heel pressed against a footrest for hours. A treating clinician who visits the home can see the setup and adjust the plan for heel protection and positioning. Gateway arranges those visits for long-time residents who want to stay in the houses they know, and coordinates supplies so protective padding and dressings are delivered there.

Brick ranch homes on quiet subdivision streets make up much of Mehlville, along with condominiums, villas and apartment complexes near Lemay Ferry Road and Lindbergh Boulevard. Senior apartments, assisted living and skilled nursing centers serve the area as well. Gateway arranges partner clinician visits in any of them. In a ranch home, the visit often happens in the bedroom or at the kitchen table. In a facility, we set it up with the nurse on the unit, and the treating clinician’s orders are shared with staff so they can follow them.

At home between visits

When a home health agency is already visiting, its nurses and the wound care clinician need to work from the same orders. Gateway shares the treating clinician’s plan with the agency, so dressing changes between wound visits follow it and nobody applies a compression wrap that was not ordered.

Supplies are handled the same way. Once the clinician writes orders for dressings, padding or protective footwear, we coordinate the supply request and follow up on delivery to the home. If dressings are left over from an earlier leg wound, show them to the clinician before using them, because an arterial wound may call for something different.

Care in skilled nursing and assisted living

In a skilled nursing facility, partner clinicians see residents with arterial or mixed wounds on site and write recommendations for the attending physician and nursing staff. Facility nurses carry out the daily dressing orders and are well placed to catch change early, since they see the foot every shift.

Gateway coordinates the visit schedule with the director of nursing or wound nurse, sends visit notes for the chart, and tracks open items such as a pending circulation test. Clear documentation of whether compression is ordered for each leg matters here, because staff rotate and a routine wrap on the wrong leg is an avoidable error.

What to report and when to call 911

For a mixed wound, watch both the swelling and the circulation. Report these to the treating clinician:

• Swelling that rises quickly or spreads up the leg
• Toes that turn pale, blue or numb, or new pain, while a wrap or stocking is on
• Drainage soaking through dressings sooner than before
• New blisters or breaks in the skin near the wound
• Fever, chills or feeling unwell

Call 911 for a leg that suddenly becomes cold, white or blue and very painful, for chest pain or trouble breathing, or for signs of stroke such as a drooping face, weakness in one arm or slurred speech.

How primary care fits in

People with arterial or mixed wounds often take a long list of medications: for blood pressure, cholesterol, diabetes, heart rhythm, fluid and pain. Some affect swelling, some affect bleeding at the wound, and pain medicine may need review as the wound changes. Only the prescribing clinician should adjust any of them, which is one reason a current primary care relationship matters.

A primary care visit at home can include a full medication review. Gateway then sends the updated list to the wound care clinician and any vascular office involved, ahead of the next appointment or procedure.

Primary care at home in Mehlville →

Getting care arranged in Mehlville

Clinicians and facility staff referring a patient for arterial and mixed wound care in Mehlville can call 314-325-0126 or fax 314-786-7966. Helpful to include: demographics and insurance, the working diagnosis, recent wound notes and measurements, current orders, the medication list and relevant test results. Please also tell us who should receive the treating clinician’s notes afterward. The online referral form takes contact details only, so clinical records should come by fax, not through the form. Gateway confirms that the referral arrived, checks availability for the patient’s address and lets your office know what has been scheduled.

Since Mehlville addresses say St. Louis, give us the ZIP code (63125 or 63129) and the nearest main road when you call, so there is no confusion with the city. Keep the patient’s phone number, doctor’s name and medication list close at hand. Gateway arranges care in nearby Oakville, Affton, Arnold, the rest of South County and South St. Louis. If relatives in different households share the caregiving, tell us who should get the call about visit days.

• County: St. Louis County, Missouri
• ZIP codes: 63125, 63129
• Nearby hospitals: Mercy Hospital South (not affiliated with Gateway)
• Nearby communities: Oakville, Affton, South County, Arnold, South St. Louis
• Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

More wound care in Mehlville

Read the full guide to arterial and mixed wounds, or see everything Gateway arranges on the mobile wound care in Mehlville page.

• Diabetic foot ulcers
• Venous leg ulcers
• Pressure injuries and bed sores
• 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
• Arterial and mixed wound care in Oakville
• Arterial and mixed wound care in Affton
• Arterial and mixed wound care in South County
• Arterial and mixed wound care in Arnold

Common questions