Understanding post-surgical wounds

Any operation carries some chance of a wound problem, but certain people and procedures call for closer watching. Older adults, people with diabetes or vascular disease, people who smoke, and those who were underweight or carrying extra weight at the time of surgery are more likely to heal slowly. So are people who had emergency surgery, a long operation, bowel surgery, an amputation, or a second procedure through an old scar. People who take steroids or medicines that quiet the immune system, and people who have trouble moving, eating or keeping the area clean after discharge, belong on the same list. None of this means a problem will happen. It means the incision deserves regular, careful follow-up.

How the care plan is built

Follow-up visits are about direction. The treating clinician compares the wound with the last visit: is the open area smaller, is drainage lighter, is the surrounding redness shrinking or holding steady? Measurements and, where appropriate, photographs for the record make that comparison objective. If the wound is moving the right way, the plan usually continues with small adjustments. If it has stalled or gone backward, the clinician looks for the reason, which may be tension on the site, trapped moisture, a fluid collection under the skin, infection or a general health issue, and decides whether the surgeon needs to see the patient sooner than planned.

Post-surgical wound care in the Riverbend

Many people in the Riverbend have surgery at an Illinois hospital, while others cross the river to a St. Louis medical center and come home to Illinois to recover. Either way, the incision needs follow-up on the Illinois side. Before arranging a visit, Gateway confirms which partner clinician can see you at your address and asks about your plan, since Illinois Medicaid, Missouri plans and Medicare Advantage plans work differently. We then gather the operative and discharge records from whichever hospital did the surgery so the treating clinician starts with the surgeon’s orders.

Each town in the Riverbend has its own housing. Wood River, Roxana, East Alton and Hartford have many compact one-story houses on a street grid, Bethalto and Godfrey have ranch homes and newer subdivisions with more land, and Alton has older houses on hills. Senior apartments, assisted living, and skilled nursing and rehabilitation centers are spread among the towns. Gateway arranges partner clinician visits in homes and facilities throughout the area, and when a patient moves from one town or setting to another, we carry the records, orders and schedule along.

When care happens at home

Many people go home after surgery with a home health agency already assigned. In that case the home health nurse usually handles routine dressing changes, and the treating clinician arranged through Gateway adds wound-focused assessments and orders. We make sure both are reading the same instructions, since two sets of dressing orders in one house is a common source of mistakes. If no agency is involved, the clinician decides who can safely change the dressing, which may be you, a family member or a nurse, and Gateway follows up on whatever that plan requires.

Care in skilled nursing and assisted living

In rehabilitation, the wound and the therapy schedule have to work together. A new knee or hip incision is bent and loaded several times a day, and an abdominal incision is strained each time a patient is helped out of bed. The treating clinician shares findings with nursing and therapy so that a draining or separating incision is noticed by the people who see it most, and so that questions about movement limits go to the surgeon instead of being guessed at. Gateway schedules visits around therapy sessions where possible and routes updates to the attending physician.

Signs to tell the clinician about

A healing incision should look a little better, or at least no worse, each day. Call the surgeon’s office or the treating clinician when the trend reverses:

  • A faint pink edge has become a wide red patch
  • A dry incision starts to leak
  • Soreness becomes throbbing or sharp
  • The area feels hot or tight
  • One calf becomes painful, swollen or warm

Do not wait on these to see what happens. Call 911 if deep tissue shows through an opened incision, if blood soaks dressings faster than you can replace them, or if you have chest pain, sudden breathlessness, fainting or new confusion.

Primary care and overall health

People leave the hospital with a changed medication list: new pain medicine, perhaps a blood thinner, an antibiotic course, stool softeners, and old prescriptions that were paused or adjusted. Some of these affect bleeding, bruising and how an incision heals, and it is easy to end up taking a duplicate or missing something that was meant to restart. A primary care clinician can go through the full list after discharge and sort out questions with the surgeon and the pharmacy. Arranging that review alongside wound visits means the wound care clinician knows what the patient is actually taking.

Primary care at home in the Riverbend →

How to get started in the Riverbend

Before anything is scheduled, Gateway checks two things for every request for post-surgical wound care in the Riverbend: 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.

The two general hospitals in the Riverbend, Alton Memorial Hospital and OSF Saint Anthony’s Health Center, are both in Alton. Patients from Wood River, Bethalto and the other towns are commonly discharged from them, and Gateway has no affiliation with either. A discharge to a home a few towns away can leave a family unsure who checks the wound next. Families can call us with that question. Discharge planners can refer by phone at 314-325-0126 or fax at 314-786-7966, and we coordinate follow-up with a partner clinician and the regular doctor.

  • County: Madison County, Illinois
  • ZIP codes: 62002, 62035, 62024, 62095, 62010
  • Nearby hospitals: Alton Memorial Hospital; OSF Saint Anthony's Health Center in Alton (not affiliated with Gateway)
  • Nearby communities: Alton, Godfrey, Illinois, Edwardsville, Granite City
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

More wound care in the Riverbend

Read the full guide to post-surgical wounds, or see everything Gateway arranges on the mobile wound care in the Riverbend page.

Common questions

Do I need a referral from my surgeon to arrange wound follow-up in the Riverbend?

No. Patients, family members and caregivers can call Gateway directly, and surgical offices and discharge planners can refer as well. Once you call, we ask for permission to request the operative report and discharge instructions, because the treating clinician needs the surgeon’s orders before making decisions about the incision. Some health plans have their own referral rules, which we help you check.

Does wound follow-up replace my appointments with the surgeon?

No. The surgeon who did the operation remains responsible for it, and you should keep every scheduled post-operative appointment. Wound follow-up fills the time between those visits. The treating clinician assesses the incision, works within the surgeon’s orders and reports findings to the surgical office, which helps the surgeon decide whether to see you sooner.

What is negative pressure wound therapy, and can it be managed outside the hospital?

Negative pressure wound therapy, sometimes called a wound vacuum, uses a sealed dressing connected to a small pump that draws fluid away from the wound. Surgeons sometimes order it for open or separated incisions. It is commonly used at home and in facilities, with dressing changes done by a trained clinician on a set schedule. Gateway helps coordinate the equipment, supplies and visits when one is ordered.

Can a nursing or rehabilitation center in the Riverbend refer a resident for wound care?

Yes. Directors of nursing, wound nurses and social workers can refer residents by calling 314-325-0126 or faxing 314-786-7966. Gateway coordinates visit times with facility staff, and the treating clinician’s assessments and orders are shared with the nurses who provide daily care. Family members of a resident can also contact us to start the request.

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.