Diabetic foot ulcer care in South County.

What to know about diabetic foot ulcers

Change in a diabetic foot ulcer comes slowly, which is why the wound is measured at regular visits. In the early weeks of care, clinicians look for the wound to become smaller and shallower and for healthy red tissue to fill in the base. A wound that stays the same size visit after visit is a signal to look for a cause instead of simply waiting longer. Setbacks are common. A few days in the wrong shoes, or a stretch without the protective device, can undo progress. Once the skin closes, the area stays weaker than the skin around it, and ulcers often return at or near the same spot. The months after closure call for protective footwear and continued foot checks.

How the care plan is built

Clinicians grade diabetic foot ulcers by severity, and the grade shapes what follows. A shallow wound with good blood flow and no infection can often be managed with visits at home or in a facility. A wound with spreading infection, exposed bone or tendon, or poor circulation may need a hospital, a surgeon or a vascular specialist, and the treating clinician will tell you if that is the case. Between those two ends, the clinician weighs what can be done on site against what calls for imaging, lab work or a specialist’s opinion. Gateway’s part is to move the resulting orders and referrals along and to let you know who should be calling you.

Arranging this care in South County

Many people in South 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.

South County is shorthand for the southern part of St. Louis County, a band of communities roughly south of Interstate 44 that reaches from the River des Peres at the city line down to the Meramec River. It includes Affton, Lemay, Mehlville, Oakville, Concord, Sappington, Green Park, Crestwood and Sunset Hills. Gravois Road, Tesson Ferry Road, Lemay Ferry Road, Telegraph Road and Lindbergh Boulevard are the roads everyone uses. People here tend to stay for life, and many are retirees. Bringing wound care and primary care to them fits the way South County lives.

Care at home

Family caregivers do much of the day-to-day work when a diabetic foot ulcer is cared for at home. A spouse or adult child may be the only person who can see the sole of the foot, hold a mirror or notice a damp sock. The treating clinician decides which dressing tasks a caregiver can take on and explains what is expected. Caregivers also help by keeping the offloading device within reach, clearing clutter from walking paths, and writing down blood sugar readings and questions for the next visit. If the tasks become more than your household can manage, tell us and we will raise it with the clinician.

Care in skilled nursing and assisted living

A resident with dementia may not remember having a foot wound, may pull off a dressing, or may refuse a boot that feels strange. Memory care teams know these patterns, and the treating clinician plans with them. That can mean choosing dressings that stay in place, timing care for a calmer part of the day, and asking staff which footwear the resident will keep on. Because the resident often cannot report pain or changes, staff observations carry extra weight. Gateway relays those observations to the clinician between visits and helps keep family members or legal decision-makers informed about the plan.

Changes to report

Whoever changes the dressing is well placed to spot trouble. Let the treating clinician know if you see any of the following:

• Drainage soaking through sooner than it used to
• The wound measuring larger, or new openings nearby
• Skin around the wound turning white, soggy or raw
• A new blister or rubbed area where the boot, cast or shoe touches
• Fresh blood on a dressing that used to come off clean

Bleeding that will not stop with firm pressure, sudden weakness, slurred speech or difficulty breathing are reasons to call 911, not to wait for a call back.

Why primary care matters here

Being told to keep weight off a foot changes daily life. A boot or cast can alter balance, raise the chance of a fall and make it harder to reach appointments, the pharmacy or the kitchen. Primary care looks at that wider picture: fall risk, vision, mood, sleep, vaccinations, and whether a walker, wheelchair or shower chair would help. For people who are homebound or have lost touch with a regular doctor, Gateway can arrange primary care visits alongside wound visits. With one coordinating point for both, it is less likely that the foot gets attention while the rest of a person’s health goes unwatched.

Primary care at home in South County →

Getting care arranged in South County

You may already have a surgeon, a wound clinic or a home health nurse and still want help with diabetic foot ulcer care closer to home in South 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.

Mercy Hospital South is the hospital most South County residents know best. SSM Health St. Clare Hospital in Fenton and St. Luke’s Des Peres Hospital are used by many people on the western and northwestern sides. None of them is affiliated with Gateway. For discharge planners, a referral by phone or fax with the summary, wound orders and a family contact is enough to start. For families, one call to 314-325-0126 before or after discharge works. We then look for a partner clinician for the patient’s home or facility and confirm what happens next.

• County: St. Louis County, Missouri
• ZIP codes: 63123, 63125, 63126, 63127, 63128, 63129
• Nearby hospitals: Mercy Hospital South; SSM Health St. Clare Hospital in Fenton; St. Luke's Des Peres Hospital (not affiliated with Gateway)
• Nearby communities: Affton, Mehlville, Oakville, Crestwood, Sunset Hills, Fenton
• Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Related care in South County

Read the full guide to diabetic foot ulcers, or see everything Gateway arranges on the mobile wound care in South 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 Affton
• Diabetic foot ulcer care in Mehlville
• Diabetic foot ulcer care in Oakville

Common questions