What to know about venous leg ulcers
A venous leg ulcer is a break in the skin of the lower leg that stays open because the veins beneath it are not doing their job. Most appear between mid-calf and ankle, commonly on the inner side near the ankle bone. They are usually shallow, with an irregular outline and a moist red or yellowish base. Drainage can be heavy enough to soak through dressings and socks.
The skin nearby tells part of the story. It may look stained brown or purple, feel tight, hard or itchy, and swell more as the day goes on. Pain varies. Some people feel a dull ache that eases when the leg is raised, and others feel very little.
What an assessment covers
The history shapes a venous ulcer plan as much as the exam does. The treating clinician asks how long the ulcer has been open, whether this leg has ulcerated before, and whether you have had a blood clot, a vein procedure, leg surgery or an injury. Allergies are reviewed, along with any skin reaction to past dressings, tapes or wraps, so the same products are not ordered again.
The clinician also asks what you have already tried and what happened. An ulcer that does not look or behave like a typical venous wound, or one that fails to respond, may lead to more tests or a referral to a vascular or skin specialist.
Venous leg ulcer care in Wildwood
In Wildwood, 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.
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.
When care happens at home
Most of the healing in a venous leg ulcer happens between visits. The treating clinician leaves instructions for those days: how long a wrap stays on, how to keep it dry, when to put your feet up, and what to do if a wrap slides down. If a wrap comes off early or drainage soaks through, call instead of waiting for the next scheduled visit. Gateway takes those calls, relays the question to the clinician and arranges whatever follows, such as a supply shipment or an earlier visit when one is available. Writing down questions as they come up makes each visit more useful.
For residents of nursing and senior living communities
Assisted living is a different setting from a nursing home. Staff may help with bathing and dressing, but licensed nursing hours are often limited, and many communities do not apply compression wraps. For a resident with a venous leg ulcer, that affects the plan. The treating clinician may choose compression that stays on between visits, or a type that a home health nurse reapplies. Gateway coordinates with the community’s nurse or wellness director, the family and any home health agency so each knows who is responsible for which task. We also ask staff to report slipped wraps, wet dressings and new swelling early.
Changes to report
Some changes point beyond the ulcer to the rest of the body. Tell the treating clinician promptly about:
- New swelling, pain or tenderness in one calf or thigh
- Swelling that rises quickly in both legs
- Rapid weight gain over a few days
- Needing more pillows to breathe comfortably at night
- A fall or a new injury to the leg
Call 911 right away for sudden shortness of breath, chest pain, coughing up blood, or a racing heartbeat with lightheadedness. These can be signs of a blood clot in the lungs or a heart problem, and they should not wait for a scheduled visit.
Primary care and overall health
Not all leg swelling comes from the veins. The heart, kidneys, liver and thyroid can each cause fluid to build up, and so can certain medicines for blood pressure, pain or diabetes. Sorting out which causes apply is primary care work, usually involving an exam, a medication review and sometimes blood tests or heart testing. That information changes wound care. A clinician planning compression wants to know, for example, whether heart failure is present and how stable it is. When Gateway arranges wound care and primary care together, findings move in both directions and the leg is not handled as if it were separate from the person.
Arranging venous leg ulcer care in Wildwood
Clinicians and facility staff referring a patient for venous leg ulcer care in Wildwood 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.
St. Luke’s Hospital in Chesterfield and Mercy Hospital St. Louis in Creve Coeur are hospitals Wildwood residents commonly use, and both are a meaningful drive from the western parts of the city. Gateway is not affiliated with either hospital. Returning for wound checks after a discharge can be tiring for the patient and the driver. Families can call us once a discharge date is known, and hospital discharge planners can refer directly. We gather records and orders and arrange follow-up with a partner clinician at home or in a facility.
- 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 venous leg ulcers, or see everything Gateway arranges on the mobile wound care in Wildwood page.
- Diabetic foot 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
- Venous leg ulcer care in Chesterfield and West County
- Venous leg ulcer care in Ballwin
- Venous leg ulcer care in Franklin County
Common questions
Can a clinician come to a home in Wildwood to care for a venous leg ulcer?
In many cases, yes. Gateway arranges visits from partner clinicians to private homes, and we confirm availability for your address and care setting when you call. The clinician assesses the leg, writes the orders and returns on the schedule they set. Call 314-325-0126 to ask. For anything life-threatening, call 911 instead.
What is the difference between a venous ulcer and an arterial ulcer?
Venous ulcers come from blood pooling in the leg. They tend to be shallow, wet and located near the ankle on a swollen leg. Arterial ulcers come from too little blood reaching the tissue and are often on the toes, foot or shin, with a dry base and pain that worsens when the leg is raised. Some people have both. Telling them apart takes a clinical exam and circulation testing.
What should I have ready before the first visit?
A few things help: a list of your medications and allergies, the names of your other clinicians, any recent hospital or clinic records about the leg, and results of circulation tests if you have had them. Keep the dressings and wraps you are using now so the clinician can see them. If a family member helps with your care, ask them to be present or available by phone.
Can Gateway help with a ride from Wildwood when a test cannot be done at home?
Yes. When the treating clinician orders something that has to happen at a hospital or an office, such as imaging or a specialist visit, Gateway can help coordinate the appointment and the transportation arrangements. Whether a ride is paid for depends on the plan and the situation, so we will go over what to ask your insurer.
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.