What to know about diabetic foot ulcers
Foot ulcers are more likely in people who have had diabetes for many years, especially once feeling in the feet has faded. Anyone who has had an ulcer or an amputation before is at higher risk, because healed skin stays fragile and the pressure pattern behind the first wound is often still there. Other things that raise risk include poor circulation in the legs, kidney disease, changes in foot shape such as hammertoes, bunions or a collapsed arch, vision loss that makes foot checks hard, and trouble bending to reach the feet. People who live alone, or who cannot easily get properly fitted shoes, are more exposed too. None of this makes an ulcer certain. It tells clinicians whose feet to watch closely.
How the care plan is built
At the first visit the treating clinician usually measures the length, width and depth of the ulcer and notes what the base looks like: pink or red tissue, yellow slough, dark dead tissue, or structures that should not be visible. The edges get attention too, because a thick rim of callus or skin that has been undermined changes the plan. The amount, color and odor of any drainage are recorded. The clinician may also check whether the wound reaches toward bone, since that raises the question of bone infection and may lead to imaging or lab work. These findings become the baseline that later visits are measured against.
Arranging this care in North County
Many people in North County have lived in the same house for decades and intend to stay. A diabetic foot ulcer tests that plan. Older homes tend to have steps at every entrance, laundry in the basement and a tub to climb into, each one a moment of full weight on the wounded foot. During home visits the treating clinician can point out practical changes, and Gateway follows up on any equipment ordered. If care needs outgrow the house, skilled nursing and rehabilitation facilities are close by, and you can ask us about continuing wound visits there.
North County is the name St. Louisans give to the northern part of St. Louis County, roughly the area north of Interstate 70. It takes in Florissant, Hazelwood, Ferguson, Bridgeton, Berkeley, Jennings, Black Jack, Bellefontaine Neighbors and unincorporated Spanish Lake, and it runs north and east to the Missouri and Mississippi rivers. Interstate 270 and Interstate 170 tie these communities together. Many families have lived here for generations, and many longtime homeowners are now older adults. Care arranged at home or in a nearby facility helps them stay close to family, church and neighbors.
When care happens at home
Most of the time a foot ulcer spends healing falls between visits, so the plan for those days matters. The treating clinician will spell out how often the dressing is changed, who changes it, how much walking is allowed and what goes on the foot indoors, including short trips to the bathroom at night. Keeping the offloading boot or shoe beside the bed makes those trips easier to do correctly. A simple daily routine helps: look at both feet, check whether drainage has soaked through the dressing, and write down anything new. If a question comes up, call Gateway and we will pass it to the treating clinician.
Care in skilled nursing and assisted living
Rehabilitation stays add a tension to foot ulcer care: therapy wants the person up and walking, and the wound needs pressure kept off it. The treating clinician and the therapy team work out how to do both, for example by setting weight-bearing limits, naming the device to be worn during sessions and deciding how transfers are done. Gateway shares the wound orders with therapy and nursing so the instructions match. Before discharge we help arrange what comes next, including wound visits at home, the supplies that leave with the resident and a clear handoff to whoever will change dressings after the move.
Signs to tell the clinician about
Infection is the change clinicians most want to hear about early, and in a numb foot it may not hurt. Contact the treating clinician promptly if you notice:
- Redness that is spreading, or a red streak moving up the foot or leg
- Skin around the ulcer that feels warmer than the other foot
- Thicker, cloudy or foul-smelling drainage
- New swelling of the foot or ankle
- Fever, chills or feeling generally unwell
Call 911 for confusion, a racing heart, trouble breathing or fainting. Gateway is not an emergency service.
How primary care fits in
Healing an ulcer takes protein, calories and fluids, and that can pull against an eating plan built around blood sugar or kidney disease. Sorting out what to eat while a wound is open is a question for the primary care clinician or a dietitian. Medications deserve the same review. Some can affect swelling, blood sugar or healing, and only the prescribing clinician should adjust them. Arranging wound care and primary care together means these questions are asked by someone with the full medication list and recent lab results in hand, not saved for an appointment that is months away.
Arranging diabetic foot ulcer care in North County
To arrange diabetic foot ulcer care in North County, call Gateway at 314-325-0126. Patients, family members and caregivers can call directly, and a referral is not required. We will ask where the patient lives, what has been done for the wound so far and which clinicians are involved. Gateway then confirms whether a partner clinician is available for that address and care setting, requests the relevant records and schedules the visit. At that visit the treating clinician examines the wound and decides on the plan. Our job from then on is the coordination: orders, supplies, follow-up visits and keeping the care team informed.
Christian Hospital, near Interstate 270, and SSM Health DePaul Hospital in Bridgeton are the two hospitals people in North County use most. Gateway is not affiliated with either one. The first days at home after discharge are when dressing questions and supply gaps tend to show up, so it helps to set up follow-up early. Families can call 314-325-0126 before the patient leaves the hospital. Discharge planners can fax referrals to 314-786-7966 with the summary and wound orders. Gateway then confirms which partner clinician can see the patient at the North County address.
- County: St. Louis County, Missouri
- ZIP codes: 63031, 63033, 63034, 63042, 63135, 63136, 63137, 63138, 63134
- Nearby hospitals: Christian Hospital in North County; SSM Health DePaul Hospital in Bridgeton (not affiliated with Gateway)
- Nearby communities: Florissant, Hazelwood, Ferguson, Bridgeton, North St. Louis
- Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation
Related care in North County
Read the full guide to diabetic foot ulcers, or see everything Gateway arranges on the mobile wound care in North County page.
- 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
- Wounds with lymphedema
- Skin graft aftercare
- Wound VAC (NPWT) follow-up
- Diabetic foot ulcer care in Florissant
- Diabetic foot ulcer care in Hazelwood
- Diabetic foot ulcer care in Ferguson
- Diabetic foot ulcer care in North St. Louis
Common questions
How do I start diabetic foot ulcer care in North County?
Call 314-325-0126 or send the request form with your name and phone number. Please leave medical details out of the form. We will call back to ask where you live, who is involved in your care and what has been tried so far. Then we confirm which partner clinician can see you and set up the first visit.
How often will the clinician visit for a diabetic foot ulcer?
The treating clinician sets the schedule based on how severe the wound is, the dressing plan and who is helping between visits. The frequency often changes as the ulcer improves or if a problem appears. Gateway does not promise a specific timetable, and visit availability is confirmed by location and care setting. If something changes before the next visit, call us so the clinician can decide what to do.
Does Medicare or Medicaid pay for diabetic foot ulcer care in North County?
We cannot say in advance. Coverage depends on the treating provider, your specific plan and the care that is ordered, and the rules for visits, dressings and offloading devices can differ. You can ask us about Medicare, Medicare Advantage, Medicaid and commercial plans. Gateway checks what it can with the provider and the plan before the first visit and tells you what we find.
Which North County communities does Gateway arrange care in?
Gateway arranges wound care and primary care across North County, including Florissant, Hazelwood, Ferguson, Bridgeton, Berkeley, Jennings, Black Jack, Bellefontaine Neighbors and Spanish Lake. That takes in ZIP codes such as 63031, 63033, 63034, 63042 and 63136. If you are not sure whether an address falls in the area, call 314-325-0126 and we will check. Availability is confirmed by location and care setting.
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.