About venous leg ulcers

Several common beliefs about venous leg ulcers get in the way of healing. One is that the sore needs air so it can dry out and scab. In general, clinicians aim for a moist, protected wound, not a dry one. Another is that the dressing does the healing. The dressing manages drainage, while compression addresses the swelling that holds the ulcer open.

A third is that resting means sitting with the feet on the floor, which lets fluid collect. People also assume a red, weeping leg must be infected, when skin inflamed by vein disease can look much the same. Each of these is worth raising with the treating clinician.

How the care plan is built

Most care plans for a venous leg ulcer are built from the same parts, each set by the treating clinician for your leg:

  • Compression, if circulation allows it
  • A dressing schedule based on drainage
  • Cleansing and protection for the surrounding skin
  • Removal of unhealthy tissue when the clinician judges it necessary
  • Guidance on elevation, walking and ankle movement
  • A date to remeasure and review

The clinician writes the orders. Gateway then coordinates what the orders require: supplies, the visit schedule, and copies of the plan for home health, facility nursing or your primary care clinician. If the ulcer is not responding, the plan is reviewed and changed.

Arranging this care in O’Fallon

In O’Fallon, a vein specialist or vascular lab can be a long drive away, and a car ride is hard on a venous ulcer. Sitting with the knees bent and feet on the floor for a long stretch each way lets fluid settle in the lower legs. When routine wrap changes and wound checks happen at home, those drives can be saved for appointments that truly need a specialist’s equipment. Gateway arranges home visits with a partner clinician, helps schedule any testing the clinician orders, and groups appointments where possible so one trip covers more than one need.

Two-story houses with the bedrooms upstairs are the norm in many O’Fallon subdivisions, which can be a problem after surgery or when a leg wound makes stairs risky. The city also has ranch-style villas, apartments, and a growing number of senior living, assisted living, memory care and skilled nursing communities. Gateway arranges partner clinician visits in all of these. For a house, we ask whether the patient is staying on the main floor. For a senior community, we coordinate with the wellness or nursing staff so they receive the treating clinician’s orders.

When care happens at home

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

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.

Signs to tell the clinician about

Compression should feel snug and supportive, not painful. Contact the treating clinician promptly if any of these occur while a wrap or garment is on:

  • Toes that look pale, bluish or darker than usual, or feel cold
  • Numbness, tingling or pins and needles in the foot
  • New or sharper pain under the wrap, particularly over the shin or ankle
  • A wrap that has rolled, slid down or formed a tight band
  • Swelling that bulges above or below the wrap

Follow the instructions you were given for these situations, including whether to take the wrap off. Call 911 if the foot or leg suddenly turns cold, pale and severely painful.

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.

Primary care at home in O'Fallon →

How to get started in O’Fallon

Clinicians and facility staff referring a patient for venous leg ulcer care in O’Fallon can call 314-325-0126 or fax 314-786-7966. Helpful to include: demographics and insurance, the working diagnosis, recent wound notes and measurements, current orders, the medication list and relevant test results. Please also tell us who should receive the treating clinician’s notes afterward. The online referral form takes contact details only, so clinical records should come by fax, not through the form. Gateway confirms that the referral arrived, checks availability for the patient’s address and lets your office know what has been scheduled.

Progress West Hospital is in O’Fallon itself. Barnes-Jewish St. Peters Hospital is to the east, and SSM Health St. Joseph Hospital in Lake Saint Louis is to the west. Gateway is not affiliated with any of the three, and patients from all of them come home to O’Fallon addresses. A daughter or spouse can call us from the hospital room to ask about follow-up. Case managers can send a referral with the discharge summary and wound orders. Gateway then checks partner clinician availability for that part of O’Fallon and reports back.

  • County: St. Charles County, Missouri
  • ZIP codes: 63366, 63368
  • Nearby hospitals: Progress West Hospital in O'Fallon; Barnes-Jewish St. Peters Hospital; SSM Health St. Joseph Hospital in Lake Saint Louis (not affiliated with Gateway)
  • Nearby communities: St. Peters, Lake St. Louis, Wentzville, Dardenne Prairie, Cottleville
  • 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 O'Fallon page.

Common questions

My mother lives in a nursing home in O’Fallon. Can Gateway arrange venous ulcer care there?

Often, yes. Partner clinicians see residents in skilled nursing, assisted living, memory care and rehabilitation settings, working alongside the facility’s nurses and the attending physician. Start by telling us the facility’s name, or ask its nursing staff to contact Gateway. We confirm whether visits are available at that location and what the facility needs in order to begin.

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.

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.

My mother just moved into my O’Fallon home from out of state. Can Gateway help her get care started?

You can ask. Gateway arranges primary care and wound care visits with partner clinicians at home, which can be useful while your mother settles in. With her permission, we request records from the doctors she saw before the move. Have her medication list and insurance cards ready when you call. Coverage depends on her plan, the treating provider and the care needed.

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.