Wound care with lymphedema in Monroe and Clinton counties.

What to know about wounds with lymphedema

Wounds form on a limb with lymphedema because swollen tissue is fragile tissue. Fluid pushes skin cells farther from the small blood vessels that feed them, so oxygen and nutrients arrive slowly. The stretched surface tears easily, and a scratch from a pet, a bump against a bed frame or a rubbing shoe can open it.

Once the skin is open, lymph fluid seeps out. The steady moisture softens the surrounding skin until it turns white and breaks down, and the open area widens. Bacteria that would normally be carried away by lymph flow linger in the tissue. Each problem feeds the next, which is why treating clinicians usually address the swelling and the wound in the same plan.

What an assessment covers

Compression is the main tool for reducing lymphedema, but it is not right for every limb on every day. Before ordering it, the treating clinician checks blood flow to the foot or hand, sometimes with a simple circulation test, because squeezing a limb with poor arterial supply can do harm. Heart and kidney conditions are reviewed, since moving fluid out of the legs places extra load on the heart. Loss of feeling in the feet also matters. A person who cannot feel a wrap digging in cannot report it.

With that information the clinician decides whether to use compression, what kind, and how firm. The decision is revisited as the limb changes.

Wound care with lymphedema in Monroe and Clinton counties

Crossing the river for a lymphedema therapy appointment can take a large part of a day from Monroe and Clinton counties, with the leg down for the whole ride. Many people would rather have wound care come to them. Before a visit is scheduled, Gateway confirms two things: the treating provider who serves your address, and how that provider works with your coverage, whether that is Medicare, an Illinois Medicaid plan or a commercial plan. Participation and benefits depend on the provider, the plan and the care needed.

Homes in Monroe and Clinton counties include farmhouses, houses on small-town streets, newer subdivisions around Columbia and Waterloo, and apartments for older adults. Assisted living and skilled nursing care are available in several of the towns and serve the countryside around them. Gateway arranges visits with partner clinicians in both. For a farmhouse or a home outside town, we ask who will be there to let the clinician in and what time of day suits the household. For facilities, we speak with the nursing staff about visit timing, the resident’s chart and the treating clinician’s orders.

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.

In a facility

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.

What to report and when to call 911

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.

Primary care and overall health

Because lymphedema lasts longer than any single wound, someone needs to hold the long view. A primary care clinician can track how often skin infections return, check the feet and toenails for the fungal problems that let bacteria in, and serve as the point of contact for the other specialists you see.

Gateway arranges wound care and primary care together for this reason. When the wound visits wind down, there is already a clinician who knows the history, the garments in use and what an early flare looks like for you. Questions such as who reorders garments, and how often the limb should be rechecked, have a place to go.

Primary care at home in Monroe and Clinton counties →

Arranging wound care with lymphedema in Monroe and Clinton counties

People asking about wound care with lymphedema in Monroe and Clinton counties 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.

Where people here go to the hospital depends on which way they drive. In Clinton County, HSHS St. Joseph’s Hospital in Breese is the local option. Monroe County residents may head to Memorial Hospital Belleville or cross the Jefferson Barracks Bridge to Mercy Hospital South. Gateway is not affiliated with these hospitals. A family member or discharge planner can contact us about follow-up before the patient leaves. We collect the discharge orders, confirm the home or facility address, and arrange a visit with a partner clinician when availability for that area is confirmed.

• County: Monroe and Clinton counties, Illinois
• ZIP codes: 62236, 62298, 62230, 62231
• Nearby hospitals: HSHS St. Joseph's Hospital in Breese; Memorial Hospital Belleville; Mercy Hospital South (not affiliated with Gateway)
• Nearby communities: Belleville, Illinois, St. Clair County, Illinois, Metro East, Oakville
• 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 Monroe and Clinton counties 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 Belleville
• Wound care with lymphedema in St. Clair County
• Wound care with lymphedema in the Metro East
• Wound care with lymphedema in Oakville

Common questions