What to know about wounds with lymphedema
People whose swelling has been present for a long time are the ones most likely to develop a lymphedema wound. That includes people who had lymph nodes removed or treated with radiation for cancer, people with long-standing vein disease in the legs, and people who have had skin infections in the same limb more than once. Severe obesity can overload the lymphatic system. So can spending most of the day seated with the legs down, which is common after a stroke, with advanced arthritis, or with heart and lung conditions that limit walking.
A smaller group is born with lymph vessels that did not form normally, and their swelling may begin in childhood or early adulthood. Older adults often have several of these causes at once.
What an assessment covers
A first assessment usually starts with the story of the swelling. The treating clinician asks when it began, whether it affects one limb or both, and whether it goes down overnight. A history of cancer treatment, leg surgery, injuries, blood clots or repeated skin infections matters, and so does the list of current medicines.
This history points to the cause, or more often the mix of causes, and that shapes the care plan. Swelling driven mostly by the lymphatic system is handled differently from swelling driven by the heart, the kidneys or the veins. The clinician may want records or test results from other offices, and Gateway gathers those ahead of the visit when it can.
Arranging this care in Mehlville
Across Mehlville, the person helping with lymphedema care is often a spouse of about the same age. Lifting a heavy leg and applying layered wraps may be more than that person can safely do, and the treating clinician takes this into account when writing orders. With senior living communities and skilled nursing facilities close by, people also move between home and rehabilitation. Gateway works to carry the compression and dressing orders across each move, so the routine does not have to be rebuilt each time.
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
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
Rehabilitation stays are hard on swollen legs. Long sessions in a wheelchair with the feet down let fluid pool, and wraps can loosen or slide during therapy. The treating clinician works with physical and occupational therapists on timing and positioning, such as when wraps are checked, how leg rests are used and how much ankle movement and walking can be built into the day.
Discharge needs planning too. Before the resident goes home, someone has to know who will apply compression, where supplies will come from and who follows the wound. Gateway can arrange for visits to continue at home, with availability confirmed by location.
Changes to report
Skin infection is the complication to watch most closely with lymphedema, because it can spread through a swollen limb quickly. Contact the treating clinician promptly if you notice:
- Redness that is new or spreading, or red streaks running up the limb
- Skin that feels hot or newly tender
- Fever, chills or body aches
- Drainage that turns cloudy, thick or foul smelling
- Pain that is clearly worse than usual
Do not wait for the next scheduled visit to mention these. Call 911 if a person with these signs becomes confused, faint, very drowsy or short of breath.
Primary care and overall health
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.
How to get started in Mehlville
For a resident of a nursing home, assisted living or memory care community in Mehlville, a request for wound care with lymphedema 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.
Mercy Hospital South is the hospital most Mehlville families know, and it is where many local patients are admitted and discharged. Gateway is not affiliated with it. If you or a relative is leaving the hospital with a wound that needs ongoing care, you can call us to ask about follow-up at home. Case managers and social workers can refer directly by phone or fax. We ask for the discharge summary, the current wound orders and a contact at the home, then confirm a partner clinician’s availability for that Mehlville address.
- 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
Related care in Mehlville
Read the full guide to wounds with lymphedema, or see everything Gateway arranges on the mobile wound care in Mehlville page.
- Diabetic foot ulcers
- 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
- Skin graft aftercare
- Wound VAC (NPWT) follow-up
- Wound care with lymphedema in Oakville
- Wound care with lymphedema in Affton
- Wound care with lymphedema in South County
- Wound care with lymphedema in Arnold
Common questions
Can a wound care clinician come to a home in Mehlville for a lymphedema wound?
Gateway arranges home visits with partner clinicians across Greater St. Louis and the Metro East, and availability in Mehlville is confirmed by address and care setting. Call 314-325-0126 to ask. It helps to have a list of your medicines, the names of the clinicians you see and any wraps or garments you have tried. The treating clinician decides what care is needed after seeing the limb.
Why does the skin on my swollen leg look thick and bumpy?
When protein-rich lymph fluid sits in the tissue for months or years, the skin responds by thickening and hardening. It may form deep creases at the ankle or grow small wart-like bumps, especially on the feet and toes. These changes are a sign of long-standing lymphedema. They make skin harder to keep clean and more likely to crack, so point them out to the treating clinician.
Will Medicare or my health plan pay for lymphedema wound care in Mehlville?
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.
Who decides how my mother’s wound is treated at her home in Mehlville?
The treating clinician does. That clinician examines the wound, makes the diagnosis and writes the orders. Clinical decisions belong to the treating clinician. Our part is arranging the visit, gathering records, coordinating supplies that are ordered and keeping you informed. If you have questions about the treatment plan for your mother, ask the treating clinician during the visit or have us pass the question along.
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.