What to know about arterial and mixed wounds

Leg arteries narrow slowly as fatty deposits build up inside their walls, a condition called peripheral artery disease. For years the body copes by widening smaller side vessels. Then demand rises: a blister from a new shoe, a nick while trimming a nail, a scrape against a wheelchair footrest. Repairing an injury takes far more oxygen than keeping intact skin alive, and the narrowed arteries cannot supply the difference. The injury stalls and becomes an ulcer.

In a mixed wound, weak vein valves add a second problem. Fluid pools in the lower leg, the tissue swells and the skin breaks down more easily, while the limited arterial flow slows every stage of repair.

What an assessment covers

Beyond the wound itself, the treating clinician gathers the history that explains it. Expect questions about:

  • How the wound started and how long it has been open
  • Pain: where, when, and what eases it
  • How far you can walk before your calves or feet hurt
  • Tobacco use, diabetes and past heart or vascular procedures
  • Shoes, slippers and whether you sleep in a bed or a recliner

The answers feed a plan with clear goals. For some people the aim is closure once circulation improves. For others, particularly when a procedure is not an option, the aim is comfort, protection and preventing infection.

Local context: Wildwood

From Wildwood, a vascular lab or specialist office can be a long drive, and for someone with a painful foot wound every trip counts. Gateway works to make each one worth it by confirming ahead of time that the referral, the wound records and any test orders have reached the office. Where the offices allow it, testing and the specialist visit are requested for a single trip. Routine wound checks happen at home, so the long drives are saved for the visits only a vascular office can provide.

Homes in Wildwood range from houses on several wooded acres at the end of a long driveway to conventional subdivisions and the more compact streets around the town center. Senior living, including assisted living and memory care, is found in Wildwood and in nearby Ellisville, Ballwin and Chesterfield. Gateway arranges visits with partner clinicians in private homes and facilities alike. For rural addresses we ask about gates, driveway conditions and pets, so the clinician arrives prepared and nobody is surprised at the door.

Care at home

When a home health agency is already visiting, its nurses and the wound care clinician need to work from the same orders. Gateway shares the treating clinician’s plan with the agency, so dressing changes between wound visits follow it and nobody applies a compression wrap that was not ordered.

Supplies are handled the same way. Once the clinician writes orders for dressings, padding or protective footwear, we coordinate the supply request and follow up on delivery to the home. If dressings are left over from an earlier leg wound, show them to the clinician before using them, because an arterial wound may call for something different.

In a facility

Assisted living staff usually help with daily routines but may not perform wound care, so arterial wounds in these communities often involve a home health agency, the resident’s own physician and family. Gateway helps connect those pieces. The treating clinician visits the resident’s apartment, and we share the plan with the nurse or wellness director, the agency and the family contact.

Aides who help with bathing and dressing can be told what to watch for on the feet, such as a new dark spot on a toe or a sock that leaves a deep groove, and whom to tell when they see it.

Signs to tell the clinician about

For a mixed wound, watch both the swelling and the circulation. Report these to the treating clinician:

  • Swelling that rises quickly or spreads up the leg
  • Toes that turn pale, blue or numb, or new pain, while a wrap or stocking is on
  • Drainage soaking through dressings sooner than before
  • New blisters or breaks in the skin near the wound
  • Fever, chills or feeling unwell

Call 911 for a leg that suddenly becomes cold, white or blue and very painful, for chest pain or trouble breathing, or for signs of stroke such as a drooping face, weakness in one arm or slurred speech.

Primary care and overall health

Two everyday factors have an outsized effect on arterial wounds: tobacco and movement. Nicotine in any form narrows blood vessels, so clinicians ask about it at nearly every visit, and a primary care clinician can talk through ways to quit when you are ready.

Walking is often encouraged for people with artery disease, yet an open foot wound may change what kind of activity is wise. Primary care and the wound clinician can agree on guidance that fits both. Gateway arranges the two services together so you hear one consistent message about activity, footwear and the goals for the leg.

Primary care at home in Wildwood →

How to get started in Wildwood

You may already have a surgeon, a wound clinic or a home health nurse and still want help with arterial and mixed wound care closer to home in Wildwood. 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.

Three things help when calling from Wildwood: the full street address, clear directions if the home is off a private road or a long way from the nearest highway, and the name of the patient’s doctor along with any recent hospital paperwork. Gateway also coordinates care in Chesterfield and West County, Ballwin, Ellisville, Eureka and Franklin County. Because Wildwood is spread out, availability is confirmed by location and care setting, and an exact address lets us plan the visit properly.

  • County: St. Louis County, Missouri
  • ZIP codes: 63005, 63011, 63021, 63038, 63040
  • Nearby hospitals: St. Luke's Hospital in Chesterfield; Mercy Hospital St. Louis in Creve Coeur (not affiliated with Gateway)
  • Nearby communities: Chesterfield, Chesterfield and West County, Ballwin, Ellisville, Eureka, Franklin County
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Related care in Wildwood

Read the full guide to arterial and mixed wounds, or see everything Gateway arranges on the mobile wound care in Wildwood page.

Common questions

Do I need a referral to ask about arterial wound care in Wildwood?

No. Patients, family members and caregivers in Wildwood can contact Gateway directly, and hospitals, facilities and physician offices can refer as well. Some health plans do require a referral or authorization before certain visits or tests, and the treating clinician may need earlier records. We explain what is needed for your situation after the first call, before a visit is scheduled.

What is an ankle-brachial index, and does it hurt?

It is a common circulation test. Blood pressure cuffs are placed on the arms and ankles, and a small handheld ultrasound device listens to the pulse while each cuff is inflated. Comparing ankle and arm pressures shows whether blood flow to the foot is reduced. The cuff squeeze can be uncomfortable for a moment, especially near a sore area, so tell the person doing the test where your wound is.

Is walking good or bad when I have a foot wound from poor circulation?

Walking is commonly recommended for artery disease in general, but an open wound on the foot changes the picture. Pressure and rubbing can hold a wound back, and the right shoe or protective device matters. Ask the treating clinician how much to walk, what to wear on the foot and whether any part of it should be kept free of weight. The answer is individual.

Which ZIP codes in Wildwood does Gateway coordinate care in?

Wildwood addresses fall in five ZIP codes: 63005, 63011, 63021, 63038 and 63040. Several are shared with neighboring cities such as Chesterfield, Ballwin and Ellisville, where Gateway also coordinates care. Rather than relying on the ZIP code alone, give us the street address and we will confirm availability for that location and care setting.

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.