Gateway Wound Care — Kansas City sends board-certified NPs directly to your home or facility for expert DFU management. No clinic trip. Medicare accepted.
Diabetes affects a significant portion of the adult population in the Kansas City metro region, with Jackson and Clay County zip codes tracking diabetes prevalence rates consistent with — and in some communities above — Missouri's statewide average of approximately 11.5% of adults. For the roughly one in seven people with diabetes who will develop a foot ulcer during their lifetime, access to specialized, consistent wound care is the single most important factor in avoiding amputation.
A diabetic foot ulcer (DFU) is an open wound or sore on the foot that fails to heal normally due to the combination of peripheral neuropathy (nerve damage causing loss of sensation) and impaired circulation common in long-standing diabetes. Because patients often cannot feel pain in the affected foot, ulcers can progress from a small skin breakdown to a deep, infected wound before the patient is even aware of the problem. By the time a DFU is discovered, it frequently requires immediate specialist-level intervention.
Gateway Wound Care — Kansas City provides in-home DFU management throughout Lee's Summit, Independence, Blue Springs, Liberty, Raytown, Gladstone, and the broader KC MO metro. Our nurse practitioners are trained in advanced wound management, including the Wagner grading scale used to categorize DFU severity, sharp and enzymatic debridement, offloading strategies, infection assessment, and NPWT (wound vac) therapy when indicated.
Gateway NPs use the Wagner classification system to assess DFU severity and determine the appropriate treatment protocol at every visit.
| Grade | Description | Our Approach |
|---|---|---|
| 0 | Intact skin with bony deformity or pre-ulcerative lesion | Prevention — offloading guidance, callus management, education |
| 1 | Superficial ulcer — skin breakdown without deeper tissue involvement | Wound bed preparation, advanced dressings, offloading |
| 2 | Deep ulcer — extends to tendon, capsule, or bone without infection | Sharp debridement, advanced dressings, NPWT consideration, specialist coordination |
| 3 | Deep ulcer with abscess or osteomyelitis | Aggressive local management, antibiotic coordination, urgent specialist referral |
| 4 | Partial forefoot gangrene | Immediate vascular/surgical referral; wound stabilization only at home |
| 5 | Full foot gangrene | Emergency referral — not appropriate for home management |
Our NPs perform sharp debridement — the removal of non-viable, necrotic, or infected tissue — at bedside. For wounds appropriate to enzymatic debridement, we select the appropriate agent and protocol. Proper debridement is the foundation of DFU healing.
Pressure relief is critical for DFU healing. We assess the patient's current footwear and activity, provide offloading recommendations, and coordinate with podiatrists for total contact casting or specialized devices when needed.
For appropriate wounds, we initiate and manage negative pressure wound therapy (NPWT) in the home or facility setting. NPWT accelerates healing in complex DFUs by promoting granulation tissue and reducing exudate.
Every DFU visit includes a systematic infection assessment — erythema, warmth, edema, purulence, probing to bone. We collect wound cultures as clinically indicated and coordinate antibiotic management with the patient's prescribing physician.
Call (314) 689-1320 or fax to (314) 689-1318. Patients, families, and referring providers throughout the KC MO metro can also submit online at woundcarekc.com/refer.
Insurance eligibility confirmed. Initial visit scheduled within 24–48 hours throughout Lee's Summit, Independence, Blue Springs, Liberty, Raytown, Gladstone, and KC proper.
A board-certified NP performs full Wagner assessment, initiates appropriate treatment, establishes a care plan, and schedules follow-up visits based on wound severity and healing trajectory.