Understanding venous leg ulcers
Leg veins have to push blood uphill. They rely on two helpers: one-way valves inside the vein, and the calf muscle, which squeezes the veins with every step. When valves wear out or are damaged by an old blood clot, blood slips backward and collects near the ankle. Pressure in those veins stays high whenever you sit or stand.
That pressure forces fluid and blood cells out into the tissue, which swells, stiffens and receives less oxygen and nourishment than healthy skin. Skin in that state is easy to injure and slow to mend. A scrape from a walker, an insect bite or scratching an itchy patch can be enough to start an ulcer.
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 St. Clair County
People in St. Clair County with venous leg ulcers sometimes see a vascular specialist in St. Louis and receive the rest of their care in Illinois. That split can leave gaps, such as test results from one side of the river never reaching the clinician who wraps the leg on the other. Gateway gathers the records, including circulation studies done before compression, and shares them with the treating clinician. When a trip across the river for specialty care is needed, we help with scheduling and transportation. Whether a Missouri-based provider can be used under an Illinois plan is checked first, not assumed.
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.
At home between visits
When a home health agency is already visiting, its nurses commonly change dressings and reapply compression between the treating clinician’s visits. Gateway shares current orders with the agency so both work from the same plan, and we pass the nurses’ observations back. Supplies need the same attention. A draining venous ulcer can go through a large amount of absorbent dressings, padding and wrap layers in a week. We coordinate orders for the supplies the clinician specifies and check in before they run low. What a health plan pays for depends on the plan, the treating provider and the care needed.
In a facility
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.
Signs to tell the clinician about
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.
Primary care and overall health
A draining venous ulcer asks a lot of the body. Protein is lost in wound fluid, and healing skin needs steady calories, protein and fluids to rebuild. Older adults with a poor appetite, dental problems or a tight food budget can fall behind without anyone noticing. A primary care clinician can check weight trends and lab work, look for anemia, and review diabetes control, since high blood sugar slows repair and raises infection risk. Body weight matters as well, because extra weight adds pressure to leg veins. None of this replaces wound care. It supports it, which is why Gateway can arrange both.
Getting care arranged in St. Clair County
Setting up venous leg ulcer care for someone in St. Clair County usually goes in this order:
- You call 314-325-0126 or send the request care form, which asks only for a name and phone number.
- Gateway talks with you about the wound, the address and the insurance.
- We confirm availability for that location and gather records for the treating clinician.
- The clinician visits, assesses the wound and writes the orders.
- We follow up on supplies, the next visit and communication with your other clinicians.
You do not need a confirmed diagnosis to start.
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
Related care in St. Clair County
Read the full guide to venous leg ulcers, or see everything Gateway arranges on the mobile wound care in St. Clair 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 Belleville
- Venous leg ulcer care in O'Fallon
- Venous leg ulcer care in Fairview Heights
- Venous leg ulcer care in Collinsville
Common questions
Who arranges long-term compression garments for patients in St. Clair 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.
Can I shower or bathe with a compression wrap on?
Most wraps need to stay dry, because a wet wrap can irritate skin and lose its hold. How you bathe depends on the type of compression ordered. Some garments come off for bathing, while layered wraps usually stay on until the next change. Ask the treating clinician what applies to you and which cover, if any, they suggest. Report a wrap that gets wet.
Will Medicare or my insurance pay for compression supplies and visits?
You can ask us about Medicare, Medicare Advantage, Medicaid and commercial plans. What is paid for depends on the treating provider, your specific plan and the care that is needed, and rules for compression garments and dressings vary a good deal from plan to plan. Gateway helps confirm the details before care starts so you can decide with clear information.
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.