About venous leg ulcers
Venous leg ulcers are more common in older adults, but age is not the only factor. People who have had a blood clot in a leg vein, varicose veins, leg surgery or a serious leg injury carry more risk. So do people who stand or sit for most of the day, people with a higher body weight, and women who have had several pregnancies. A family history of vein trouble is common.
Anything that keeps the ankle from bending, such as arthritis, an old fracture or weakness after a stroke, also plays a part. Many people notice years of warning signs first: ankles that swell by evening, legs that feel heavy, and skin that slowly darkens above the ankle.
What an assessment covers
The history shapes a venous ulcer plan as much as the exam does. The treating clinician asks how long the ulcer has been open, whether this leg has ulcerated before, and whether you have had a blood clot, a vein procedure, leg surgery or an injury. Allergies are reviewed, along with any skin reaction to past dressings, tapes or wraps, so the same products are not ordered again.
The clinician also asks what you have already tried and what happened. An ulcer that does not look or behave like a typical venous wound, or one that fails to respond, may lead to more tests or a referral to a vascular or skin specialist.
Arranging this care in Monroe and Clinton counties
On the Illinois side of the river, venous ulcer care involves a different set of health plans and hospitals. If you live in Monroe and Clinton counties, your coverage may be Illinois Medicaid, a Medicare Advantage plan offered in Illinois, or an employer plan, and each has its own rules for visits, compression garments and dressings. Gateway confirms the treating provider and your plan details before the first visit, so you know where things stand. We cannot say in advance what a plan will pay. Benefits depend on the treating 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.
When care happens at home
Family caregivers often carry part of the work for a venous leg ulcer at home. Depending on the orders, that might mean helping with a stocking or adjustable garment, changing an outer dressing, propping the legs at rest, or watching the toes and skin for changes. No one should have to guess. The treating clinician can show a caregiver which tasks are theirs and which to leave alone, and Gateway can request visit times when the caregiver is able to be there. If the caregiver works, travels or lives elsewhere, tell us, and with your permission we will keep them informed by phone.
In a facility
In a skilled nursing facility, venous leg ulcer care is shared work. The partner clinician sees the resident on site, assesses the ulcer and the circulation, and writes or recommends orders in line with the facility’s process. Nursing staff carry out dressing changes and compression between visits and document what they see. Gateway keeps the two connected by scheduling rounds with the facility, sending visit notes and following up on open questions. The attending physician stays informed and remains in charge of the resident’s overall medical care, including the heart, kidney and medication issues that affect leg swelling.
What to report and when to call 911
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.
Why primary care matters here
Venous disease is a long-term condition, and the ulcer is one episode in it. Once the skin closes, someone needs to keep watching the legs, renew orders for compression garments as they wear out, and decide whether a referral to a vein specialist makes sense. That ongoing role usually belongs to primary care. A primary care clinician also weighs how other treatments affect the leg, such as blood thinners after a clot or a change in blood pressure medicine. For patients without a regular clinician, or who can no longer get to an office, Gateway can arrange primary care visits alongside wound care so follow-up continues.
Arranging venous leg ulcer care in Monroe and Clinton counties
If you have been managing a wound mostly on your own and are looking for venous leg ulcer care in Monroe and Clinton counties, 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.
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
Related care in Monroe and Clinton counties
Read the full guide to venous leg ulcers, or see everything Gateway arranges on the mobile wound care in Monroe and Clinton counties page.
- Diabetic foot 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
- Venous leg ulcer care in Belleville
- Venous leg ulcer care in St. Clair County
- Venous leg ulcer care in the Metro East
- Venous leg ulcer care in Oakville
Common questions
Do I need a referral to start venous leg ulcer care in Monroe and Clinton counties?
No referral is needed to call Gateway. Patients, family members and caregivers can contact us directly, and hospitals, facilities and practices can refer as well. Some health plans have their own referral or authorization rules, which depend on the plan and the treating provider. We will tell you what records or orders the treating clinician needs before a first visit.
Could a leg ulcer that will not heal be something other than a venous ulcer?
Yes. Poor arterial circulation, diabetes, pressure, inflammatory conditions, certain infections and, rarely, skin cancer can all cause leg wounds that resemble venous ulcers. That is one reason the clinician reassesses an ulcer that is not responding as expected. Further circulation testing, lab work, a tissue sample or a specialist referral may be ordered. Raise the question directly if you are worried.
What should I have ready before the first visit?
A few things help: a list of your medications and allergies, the names of your other clinicians, any recent hospital or clinic records about the leg, and results of circulation tests if you have had them. Keep the dressings and wraps you are using now so the clinician can see them. If a family member helps with your care, ask them to be present or available by phone.
Can follow-up be arranged at home in Monroe and Clinton counties after a discharge from a Missouri hospital?
Yes, you can request it. Some Monroe County residents are treated at Mercy Hospital South or other Missouri hospitals and then return home across the river. Tell us the hospital, the discharge date and the home address. Gateway requests the discharge records and orders, and arranges follow-up with a partner clinician once availability for the Illinois address is confirmed. Gateway is not affiliated with the hospital.
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.