Understanding wounds with lymphedema
People whose swelling has been present for a long time are the ones most likely to develop a lymphedema wound. That includes people who had lymph nodes removed or treated with radiation for cancer, people with long-standing vein disease in the legs, and people who have had skin infections in the same limb more than once. Severe obesity can overload the lymphatic system. So can spending most of the day seated with the legs down, which is common after a stroke, with advanced arthritis, or with heart and lung conditions that limit walking.
A smaller group is born with lymph vessels that did not form normally, and their swelling may begin in childhood or early adulthood. Older adults often have several of these causes at once.
How the care plan is built
The care plan for a lymphedema wound has to fit the person who will live with it. The treating clinician weighs practical questions alongside the clinical ones:
- Can you reach your own feet, and do you have the hand strength to manage wraps or garments?
- Who is available to help, and at what times of day?
- Where do you rest, and can the limb be raised there?
- What will you wear on your feet over the wraps?
The answers shape the orders. A plan built on a garment that nobody in the house can put on will not last. Gateway then coordinates the supplies, any home health involvement and the follow-up schedule the clinician sets.
Wound care with lymphedema in St. Clair County
For people in St. Clair County, lymphedema care often spans two states. Cancer treatment or vascular care may have happened at a St. Louis hospital, while primary care, home health and the health plan are based in Illinois. Records sit on both sides of the river. Gateway gathers them and confirms first which partner clinician can see you in Illinois. Illinois Medicaid and Missouri plans follow different rules, and benefits for compression garments, wraps and dressings vary, so coverage questions are raised before visits begin.
A visit in St. Clair County might be to a brick house in Belleville, a ranch home in Swansea, an apartment in East St. Louis, a newer subdivision in O’Fallon or Shiloh, or a farmhouse outside Freeburg. It might also be to an assisted living community, a memory care unit, a rehabilitation center or a skilled nursing facility. Gateway arranges care with partner clinicians in each setting. We ask who is involved in the patient’s daily care, coordinate timing with that person or with facility staff, and get records and orders to the treating clinician ahead of the visit.
When care happens at home
Most of the work on a lymphedema wound happens between visits. The treating clinician leaves instructions for the days in between, and they usually cover washing and thoroughly drying the skin, using a moisturizer if one is ordered, keeping wraps or garments on as directed and resting with the limb raised.
Wraps slip, dressings soak through and questions come up. Ask at the visit whom to call when that happens and what to do in the meantime, so no one is left guessing on a weekend. If part of the routine is not working, say so. A plan can be adjusted, but only if the clinician hears about the problem.
For residents of nursing and senior living communities
A resident with lymphedema usually has other conditions that the attending physician is managing, and several of them influence swelling. The treating wound clinician and the attending physician need the same information: what the wound looks like, what compression is in place, and whether fluid, weight or medicines have changed.
Gateway handles the paperwork side of that exchange. Visit findings and recommended orders go to the attending physician and the director of nursing, and relevant labs or notes from the facility come back to the wound clinician. Each clinician keeps authority over their own decisions, and the facility keeps one clear record.
Changes to report
Skin infection is the complication to watch most closely with lymphedema, because it can spread through a swollen limb quickly. Contact the treating clinician promptly if you notice:
- Redness that is new or spreading, or red streaks running up the limb
- Skin that feels hot or newly tender
- Fever, chills or body aches
- Drainage that turns cloudy, thick or foul smelling
- Pain that is clearly worse than usual
Do not wait for the next scheduled visit to mention these. Call 911 if a person with these signs becomes confused, faint, very drowsy or short of breath.
Primary care and overall health
Lymph flow in the legs gets much of its push from the calf and foot muscles squeezing with each step, so anything that limits walking tends to worsen swelling. Primary care can look at what is holding a person back, whether that is joint pain, breathlessness, weakness or fear of falling, and whether therapy would help.
General health affects the wound as well. Healing draws on protein and calories, high blood sugar slows repair and raises infection risk, and extra body weight adds pressure on lymph vessels in the groin and legs. These are long-term concerns that a primary care clinician follows alongside the wound visits.
Arranging wound care with lymphedema in St. Clair County
Before anything is scheduled, Gateway checks two things for every request for wound care with lymphedema in St. Clair County: whether a partner clinician serves that address and care setting, and what the patient’s plan requires from the treating provider. Neither is assumed. If both line up, we arrange the visit and gather records. If something stands in the way, we say so, and our guide to following up on a request explains what to ask next. Gateway coordinates the care and does not make clinical decisions. Those belong to the treating clinician who sees the wound. Start by calling 314-325-0126, or ask a family member to call for you.
People in St. Clair County are commonly discharged from four hospitals: Memorial Hospital Belleville, Memorial Hospital Shiloh, HSHS St. Elizabeth’s Hospital in O’Fallon, Illinois and Touchette Regional Hospital in Cahokia Heights. None is affiliated with Gateway. For discharge planners, a referral by phone or fax with the face sheet, orders and destination is enough to begin. For families, a phone call with the patient’s name, the hospital and the expected discharge date does the same. Gateway then arranges follow-up with a partner clinician at the home or facility, subject to availability for that location.
- County: St. Clair County, Illinois
- ZIP codes: 62220, 62221, 62223, 62226, 62269, 62208, 62258, 62254
- Nearby hospitals: Memorial Hospital Belleville; Memorial Hospital Shiloh; HSHS St. Elizabeth's Hospital in O'Fallon, Illinois; Touchette Regional Hospital in Cahokia Heights (not affiliated with Gateway)
- Nearby communities: Belleville, Illinois, O'Fallon, Illinois, Fairview Heights, Collinsville, Metro East
- Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation
More wound care in St. Clair County
Read the full guide to wounds with lymphedema, or see everything Gateway arranges on the mobile wound care in St. Clair County 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 O'Fallon
- Wound care with lymphedema in Fairview Heights
- Wound care with lymphedema in Collinsville
Common questions
Can Gateway arrange lymphedema wound care in a nursing home or assisted living community in St. Clair County?
Yes, we arrange visits in skilled nursing, assisted living, memory care and rehabilitation settings, subject to availability for that location. A facility nurse, social worker or attending physician can refer, and so can a family member. The treating clinician coordinates with facility staff on dressing changes and compression, and Gateway handles scheduling and paperwork between the facility and the clinician.
What shoes can I wear over compression wraps?
Wraps add bulk, and many regular shoes will not fit over them. Forcing a foot into a tight shoe can rub the skin or change how the compression sits, and walking in loose slippers raises the risk of a fall. Tell the treating clinician if you cannot get footwear on. Adjustable shoes or other options may be suggested, and the plan can sometimes be changed to make walking safer.
Could a compression pump help my lymphedema wound?
A pneumatic compression pump is a sleeve that inflates and deflates in sequence to move fluid out of a limb. Some people with lymphedema use one at home as part of a larger plan. It is not suitable for everyone, and concerns such as heart conditions, blood clots or active infection have to be considered first. The treating clinician decides. If one is ordered, Gateway coordinates the documentation and the equipment order.
What should a St. Clair County discharge planner send with a referral?
Send the patient’s demographics and contact information, the discharge destination, the reason for referral, the wound or follow-up orders, a medication list and the most recent progress notes. Insurance information helps as well. Referrals can be faxed to 314-786-7966 or called in to 314-325-0126. If the destination changes before discharge, let us know so availability can be confirmed for the new location.
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.