What to know about wounds with lymphedema
Several common beliefs about lymphedema wounds cause trouble. One is that a leaking leg should be left uncovered to dry out. In practice, uncontrolled drainage damages the skin around it, and the treating clinician will usually choose a dressing that manages the moisture. Another is that swelling is simply part of aging or weight and nothing can be done. Swelling has causes, and many of them can be managed.
People also assume that a tighter wrap works better, or that old stockings from a drawer will do. Compression that is wrong for the limb can injure it. And some think the work ends when the wound closes. The swelling remains, and so does the need for daily skin care.
How the care plan is built
During the exam, the treating clinician looks at the wound and at all of the skin on the limb, since the next problem often starts a few inches from the current one. Typical points of attention include:
- Where the wound sits, its size and depth, and what the wound bed looks like
- How much it drains and what the fluid looks like
- Skin folds, including the base of each fold
- The spaces between the toes, where cracks and fungal infections hide
- Warmth, redness or tenderness that could mean infection
These findings guide the choice of dressing, how often it is changed, and whether an infection has to be dealt with before anything else.
Arranging this care in South County
Many people in South County have lived in the same house for decades and have managed swollen legs on their own for nearly as long, often with worn stockings and a routine that worked until the skin opened. Older homes add their own difficulties: a tub to step over when legs need washing, a bathroom up the stairs, a favorite chair with no way to raise the feet. A treating clinician visiting at home can see these and suggest workable changes. Gateway coordinates the visit and any garments or supplies ordered.
Care settings in South County are varied. Affton and Lemay have small brick bungalows and older two-bedroom homes. Concord, Sappington and Mehlville are known for ranch houses. Oakville and Sunset Hills have newer and larger homes. Throughout the area there are condominiums, senior apartments, assisted living, memory care and many skilled nursing and rehabilitation centers. Gateway arranges partner clinician visits in all of them. We fit the request to the setting, whether that means a kitchen-table visit in Affton or a visit planned with the nursing staff at a facility.
At home between visits
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
Small changes in the skin of a limb with lymphedema are worth reporting early, while they are easier to deal with. Let the treating clinician know about:
- A wound that is getting larger or deeper
- A clear increase in leaking, or dressings that soak through faster than before
- New blisters, raw patches or cracks, especially in skin folds
- Skin around the wound that turns white, soggy or sore
- Itching, scaling or splits between the toes
- A new or stronger odor
Call 911 for heavy bleeding that does not stop with firm pressure, or if the person becomes confused or hard to wake.
Primary care and overall health
Not all of the fluid in a swollen leg comes from the lymphatic system. Heart failure, kidney disease and liver disease can each add to it, and long-standing swelling from any of them wears on the lymph vessels over time. A primary care clinician keeps track of these conditions through exams, weights and lab work.
That information matters to the wound plan. How firmly a limb can be compressed, and how fast, depends in part on how well the heart can handle fluid moving back into circulation. When Gateway arranges both wound care and primary care, each clinician can see what the other has found and ordered.
Getting care arranged in South County
People asking about wound care with lymphedema in South County usually want to know what the first visit involves. Before it, Gateway collects the records the treating clinician asks for and confirms the time and place with you. During it, the clinician looks at the wound and the skin around it, measures it, asks about your health and medications and explains what they recommend. Afterward, the orders go to whoever does the daily care, supplies are requested and a follow-up is planned. Our guide to how mobile wound care visits work has more. To begin, call 314-325-0126. Whether a visit can be arranged is confirmed for your location.
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
More wound care in South County
Read the full guide to wounds with lymphedema, or see everything Gateway arranges on the mobile wound care in South 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 Affton
- Wound care with lymphedema in Mehlville
- Wound care with lymphedema in Oakville
Common questions
Can Gateway arrange lymphedema wound care in a nursing home or assisted living community in South 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.
Can I shower with a lymphedema wound and compression wraps?
Ask the treating clinician, because the answer depends on the dressing and the type of compression. Some wraps are meant to stay on and stay dry for several days, while others come off daily. Clean skin matters a great deal with lymphedema, so the clinician will explain how washing fits into your routine and how to protect anything that must not get wet.
What does a lymphedema therapist do, and would I still need wound care?
A lymphedema therapist is a physical or occupational therapist with added training in reducing lymphatic swelling through specialized massage, bandaging, exercise and garment fitting. A therapist does not replace the clinician who manages an open wound. The two often work on the same limb at different stages. The treating clinician decides whether and when a therapy referral makes sense, and Gateway can coordinate the referral paperwork.
My parents live in South County, one at home and one in a nursing facility. Can Gateway help with both?
Yes. Gateway arranges care in private homes and in skilled nursing, assisted living and memory care settings across South County, so both parents can be part of one conversation. Each parent may have a different treating clinician depending on location and needs. Tell us who the main family contact is, and with your parents’ permission we will keep that person informed about visits and orders for both.
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.