Understanding venous leg ulcers

A venous leg ulcer is a break in the skin of the lower leg that stays open because the veins beneath it are not doing their job. Most appear between mid-calf and ankle, commonly on the inner side near the ankle bone. They are usually shallow, with an irregular outline and a moist red or yellowish base. Drainage can be heavy enough to soak through dressings and socks.

The skin nearby tells part of the story. It may look stained brown or purple, feel tight, hard or itchy, and swell more as the day goes on. Pain varies. Some people feel a dull ache that eases when the leg is raised, and others feel very little.

How the care plan is built

Before anything is wrapped, the treating clinician needs to know that the arteries in the leg can tolerate pressure. That usually means feeling for pulses in the foot, and often a bedside test that compares blood pressure at the ankle with blood pressure in the arm. If the result is unclear, further vascular testing may be ordered.

This step matters because some leg ulcers involve both vein and artery disease, and those call for a different plan. Once circulation is understood, the clinician decides whether compression is appropriate, which form to use and how firm it should be. The dressing choice follows, matched mainly to how much the ulcer drains.

Venous leg ulcer care in Mehlville

Many people with venous leg ulcers in Mehlville 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.

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.

Care at home

When a home health agency is already visiting, its nurses commonly change dressings and reapply compression between the treating clinician’s visits. Gateway shares current orders with the agency so both work from the same plan, and we pass the nurses’ observations back. Supplies need the same attention. A draining venous ulcer can go through a large amount of absorbent dressings, padding and wrap layers in a week. We coordinate orders for the supplies the clinician specifies and check in before they run low. What a health plan pays for depends on the plan, the treating provider and the care needed.

Care in skilled nursing and assisted living

A short rehabilitation stay after surgery or a hospital admission can be a turning point for a venous leg ulcer. Legs often swell more after days in bed and long hours in a wheelchair with the feet down. Therapy sessions, on the other hand, rebuild the walking and ankle movement that help veins work. Partner clinicians see patients on site and coordinate with nursing and therapy on details such as wrap changes around therapy times and footwear that fits over compression. Before discharge, Gateway helps line up continued visits and supplies at home so the plan does not lapse during the move.

Signs to tell the clinician about

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

The calf muscle acts as a pump for the leg veins, and it only works when the ankle moves. Arthritis, nerve damage, an old injury, pain from the ulcer itself or fear of falling can shrink a person’s walking to a few steps a day. A primary care clinician can look at what is limiting movement, manage pain, review fall risk and order physical therapy or equipment when appropriate. Sleep is part of this too. People who sleep upright in a recliner because of breathing trouble or back pain keep their legs down all night, and the reason behind that habit needs a medical answer.

Primary care at home in Mehlville →

How to get started in Mehlville

People asking about venous leg ulcer care in Mehlville usually want to know what the first visit involves. Before it, Gateway collects the records the treating clinician asks for and confirms the time and place with you. During it, the clinician looks at the wound and the skin around it, measures it, asks about your health and medications and explains what they recommend. Afterward, the orders go to whoever does the daily care, supplies are requested and a follow-up is planned. Our guide to how mobile wound care visits work has more. To begin, call 314-325-0126. Whether a visit can be arranged is confirmed for your location.

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

More wound care in Mehlville

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

Common questions

Can a clinician come to a home in Mehlville to care for a venous leg ulcer?

In many cases, yes. Gateway arranges visits from partner clinicians to private homes, and we confirm availability for your address and care setting when you call. The clinician assesses the leg, writes the orders and returns on the schedule they set. Call 314-325-0126 to ask. For anything life-threatening, call 911 instead.

How often will someone visit for a venous ulcer?

The treating clinician sets the schedule based on the leg. Heavy drainage or newly started compression often calls for more frequent changes, and visits may spread out as swelling and drainage settle. Home health nurses or facility staff sometimes handle changes in between. Gateway cannot promise a specific frequency or timing, since availability is confirmed by location and care setting.

Is it normal for a venous leg ulcer to hurt?

Many do, though the amount of pain varies widely. Aching and heaviness that ease with elevation are common. Pain at dressing changes can sometimes be reduced with a different dressing or approach, so mention it. Pain that suddenly gets worse, or pain with spreading redness, fever or cold, discolored toes, should be reported to the treating clinician promptly and not waited out.

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.