What to know about 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
A plan for a venous leg ulcer has to work on ordinary days, so the treating clinician looks at how you live with the leg. Can you bend far enough to reach your foot? Do your hands have the grip to pull on a stocking? Who is in the house to help, and how often? What shoes fit over a wrap?
The answers guide the kind of compression that is ordered. Layered wraps applied by a clinician suit some people. An adjustable garment that a caregiver can manage suits others. A plan that fits your routine is more likely to stay on the leg, and compression only helps while it is worn.
Arranging this care in North County
Homes in North County are often older houses with upstairs bedrooms, basement laundry and a bathtub you have to step over. Each matters with a wrapped leg. Climbing in and out of a tub while keeping compression dry is a fall risk, and stairs may be the reason someone starts sleeping in a recliner with the legs down. During a home visit, the treating clinician can see all of this and suggest practical changes, and Gateway can coordinate ordered equipment such as a shower chair or a leg-elevating cushion. For long-time residents who want to stay put, those details matter.
Much of North County was built as subdivisions of brick ranch homes and bungalows, and those one-story houses suit home visits well. The region also has apartment complexes, senior apartment buildings, assisted living and a number of skilled nursing and rehabilitation centers. Gateway arranges partner clinician visits across all of them, from a house in Florissant to a nursing facility in Bridgeton. For a home visit, we ask where the patient is most comfortable being seen. For a facility, we ask which days work on the unit. The treating clinician handles the clinical side.
At home between visits
At a home visit, the partner clinician removes the old wrap and dressing, checks the skin, measures the ulcer and the swelling, and reapplies what was ordered. Seeing the home helps. The clinician can look at the chair where you spend most of the day, whether a footstool or recliner raises your legs, and how far you walk to the bathroom or kitchen. Details like these often explain why a leg is more swollen on some days than others. Gateway schedules the visits, confirms the day with you or a family member, and passes the clinician’s notes and orders to the others involved in your care.
For residents of nursing and senior living communities
Residents in memory care may not understand why a leg is wrapped. They may pull at the bandage, scratch the skin beneath it or be unable to say that it feels too tight. The treating clinician takes that into account when choosing dressings and compression, and may adjust the plan when a resident does not tolerate a wrap. Staff observations carry extra weight here. Restlessness, guarding the leg, a change in walking or a new refusal to wear shoes can all signal discomfort. Gateway shares the clinician’s instructions with the care team and keeps the family or legal representative updated on visits and changes.
What to report and when to call 911
Venous leg ulcers can become infected, and infection in the skin of the leg can spread. Report these changes to the treating clinician promptly:
- Redness, warmth or swelling that is spreading beyond the ulcer
- Pain that is getting worse instead of better
- Thick, cloudy or foul-smelling drainage
- Fever, chills or feeling generally unwell
- An ulcer that is suddenly larger or deeper
Call 911 for chest pain, shortness of breath, confusion or fainting, or bleeding from the leg that does not stop with firm, steady pressure.
How primary care fits in
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.
How to get started in North County
You may already have a surgeon, a wound clinic or a home health nurse and still want help with venous leg ulcer care closer to home in North County. That is a fine reason to call 314-325-0126. Tell us who is treating the wound now and what is not working, whether that is the travel, the gaps between appointments or unclear instructions. Gateway does not replace your current clinicians. We can arrange for a partner clinician to see the wound where you live and, with your permission, share notes with the offices already involved so the plans agree.
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
Other conditions and nearby communities
Read the full guide to venous leg ulcers, or see everything Gateway arranges on the mobile wound care in North County 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 Florissant
- Venous leg ulcer care in Hazelwood
- Venous leg ulcer care in Ferguson
- Venous leg ulcer care in North St. Louis
Common questions
Who arranges long-term compression garments for patients in North County once an ulcer has closed?
The treating clinician or your primary care clinician decides whether you need ongoing compression and at what strength. Garments usually require measuring, and they wear out and need replacing. Gateway can coordinate the order, the fitting and reminders for replacement, and can arrange primary care follow-up if you do not have a regular clinician. Payment for garments depends on your plan.
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.
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.
My mother in North County does not drive. Can care come to her, or does she need a ride?
Most of what Gateway arranges happens where the patient lives, so your mother would not need a ride for a home visit. If the treating clinician recommends a test or an outpatient appointment somewhere else, Gateway can help with transportation arrangements. Tell us about her situation when you call, including whether she uses a wheelchair or walker and who is usually with her.
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.