What to know 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.

What the treating clinician looks at

A first visit for a venous leg ulcer covers more than the wound. The treating clinician typically records:

  • Where the ulcer sits, and its length, width and depth
  • The appearance of the wound base and edges
  • How much drainage there is and what it looks like
  • The surrounding skin: staining, hardening, rash, or pale soggy areas
  • Swelling in both legs, often measured at the ankle and calf
  • Pain, and what makes it better or worse

Those findings become the baseline. The same points are checked again at later visits, so the care plan is adjusted on what the leg is doing, not on guesswork.

Local context: Webster Groves

Homes in Webster Groves are often older houses with upstairs bedrooms, basement laundry and a bathtub you have to step over. Each matters with a wrapped leg. Climbing in and out of a tub while keeping compression dry is a fall risk, and stairs may be the reason someone starts sleeping in a recliner with the legs down. During a home visit, the treating clinician can see all of this and suggest practical changes, and Gateway can coordinate ordered equipment such as a shower chair or a leg-elevating cushion. For long-time residents who want to stay put, those details matter.

Large frame and brick houses are common in Webster Groves, often with the bedrooms and the only full bathroom upstairs. There are also smaller bungalows, apartments and condominiums near the business districts, and senior living that includes independent apartments, assisted living and skilled nursing care in and around the city. Gateway arranges visits with partner clinicians in each of these settings. In a private home, the clinician can see where the patient actually sleeps, sits and bathes, which often matters for a wound. In a facility, we coordinate timing and orders with the staff.

When care happens at home

Family caregivers often carry part of the work for a venous leg ulcer at home. Depending on the orders, that might mean helping with a stocking or adjustable garment, changing an outer dressing, propping the legs at rest, or watching the toes and skin for changes. No one should have to guess. The treating clinician can show a caregiver which tasks are theirs and which to leave alone, and Gateway can request visit times when the caregiver is able to be there. If the caregiver works, travels or lives elsewhere, tell us, and with your permission we will keep them informed by phone.

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.

Why primary care matters here

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.

Primary care at home in Webster Groves →

Arranging venous leg ulcer care in Webster Groves

Before anything is scheduled, Gateway checks two things for every request for venous leg ulcer care in Webster Groves: 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.

After a hospital stay, Webster Groves residents often come home from SSM Health St. Mary’s Hospital in Richmond Heights, St. Luke’s Des Peres Hospital or Mercy Hospital South. None of these hospitals is affiliated with Gateway. If the discharge plan includes wound care, or the patient needs primary care follow-up and cannot easily get out, the family or the hospital’s discharge planner can contact us. We collect the discharge summary and orders, coordinate with a partner clinician and arrange follow-up visits where the patient is recovering.

  • County: St. Louis County, Missouri
  • ZIP codes: 63119
  • Nearby hospitals: SSM Health St. Mary's Hospital in Richmond Heights; St. Luke's Des Peres Hospital; Mercy Hospital South (not affiliated with Gateway)
  • Nearby communities: Kirkwood, Shrewsbury, Maplewood, Brentwood, Crestwood, Affton
  • 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 Webster Groves page.

Common questions

Do I need a referral to start venous leg ulcer care in Webster Groves?

No referral is needed to call Gateway. Patients, family members and caregivers can contact us directly, and hospitals, facilities and practices can refer as well. Some health plans have their own referral or authorization rules, which depend on the plan and the treating provider. We will tell you what records or orders the treating clinician needs before a first visit.

Should I walk or rest with a venous leg ulcer?

Usually some of each, as directed by your clinician. Walking and ankle movement work the calf muscle that pushes blood up the leg, while resting with the legs raised lets swelling drain. Long periods of standing still or sitting with the feet down tend to help least. Ask the treating clinician what balance is right for you, especially if you have heart, artery or balance problems.

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.

Is there a Gateway clinic in Webster Groves that I can walk into?

No. Gateway does not run a walk-in clinic in Webster Groves, and our administrative office in Chesterfield does not see patients. Care is arranged where the patient lives, at home or in a facility, or in an outpatient or office setting with a clinical partner when that fits. To get started, call 314-325-0126 or use the request form.

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.