About surgical site infections

Anyone who has an operation can develop an infection at the incision, but some situations raise the odds. People with diabetes, people who smoke, and people who carry a lot of weight around the surgical area are affected more often. So are those who take steroids or other medicines that quiet the immune system, and those who were poorly nourished going into surgery. The operation counts too. Emergency procedures, long operations and surgery on the bowel carry more risk than short, planned procedures through clean skin. Older adults and people who spend most of the day in a bed or chair also need a closer watch. None of this is about blame. It tells the care team who should be checked earlier and more often.

How the care plan is built

A care plan for an infected surgical wound answers a few practical questions. How will drainage be handled so the surrounding skin stays dry? Does a deep area need to be filled lightly so it does not seal over at the top? How often should the dressing be changed, and by whom? The treating clinician chooses dressings to match the wound as it is today and expects to change them as it becomes shallower and drier. If the surgeon has ordered negative pressure wound therapy, the plan covers the device as well. Everything is written as orders that home health nurses, facility nurses or family can follow.

Local context: Alton and the Riverbend

People in the Riverbend may have had surgery at an Illinois hospital or across the river in Missouri, and the wound follow-up has to connect with whichever team did the operation. Coverage adds a step. Illinois Medicaid plans, Missouri plans, Medicare Advantage and commercial insurance each work differently, and participation depends on the treating provider. Before a first visit for an infected incision, Gateway confirms which partner clinician can see you on the Illinois side and what your plan requires, then requests the surgical records from the hospital, whichever state it is in.

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

Most of the work with an infected incision happens on the days nobody visits. Someone has to change the dressing as ordered, notice what the old one looks like and keep track of how you feel. Many families keep a simple notebook by the supplies: the date, how much drainage was on the dressing, the temperature if the clinician asked for it, and any questions. That record makes each visit more useful. If changing a deep dressing is more than a spouse or adult child can manage, tell us. Gateway can ask the treating clinician about a home health referral so a nurse shares the load.

Care in skilled nursing and assisted living

In a rehabilitation setting, an infected incision has to share the day with therapy. Dressing changes work best when they are timed so a leaking or painful wound does not cut a session short, and therapists need to know about any movement limits the surgeon has set. Some residents are also receiving intravenous antibiotics through a long-term line, which facility nurses manage under the prescriber’s orders. The treating clinician watches how the wound responds and tells the attending physician and surgeon what it shows. Gateway helps keep track of the dates that matter, including antibiotic end dates, surgeon rechecks and the planned discharge.

What to report and when to call 911

An infection that was settling can flare again, and the first clues are not always at the incision. Tell the treating clinician or the surgical team promptly about:

  • A temperature above the level your surgeon told you to report
  • Shaking chills or drenching sweats
  • Pain that climbs after days of easing
  • Nausea, poor appetite or unusual tiredness that is new
  • Blood sugar readings running higher than usual, if you check them

Call 911 if the person becomes confused, is hard to wake, breathes fast or with effort, has a racing heartbeat, or faints. Those signs can mean the infection is spreading through the body.

Why primary care matters here

Rebuilding tissue in an open surgical wound takes protein, calories and fluid, at a time when appetite is often poor. Nausea from antibiotics, pain medicine and simply feeling unwell after an operation can cut intake for weeks. A primary care clinician can look at weight, eating and lab results where needed, and suggest practical steps or a dietitian referral. Tobacco is the other large factor. Nicotine narrows small blood vessels and reduces the oxygen reaching the incision, so support for cutting down or quitting is part of wound recovery. Arranging primary care with wound care keeps these conversations from being put off.

Primary care at home in the Riverbend →

Getting care arranged in the Riverbend

For a resident of a nursing home, assisted living or memory care community in the Riverbend, a request for wound follow-up after a surgical site infection can come from the family, the resident or the facility’s nurses. Call 314-325-0126 and give us the facility name, the unit or room and the best nurse contact. Gateway speaks with the facility about its process for outside clinicians, confirms availability and coordinates a visit time that fits the resident’s day. After the visit, the treating clinician’s orders are given to facility nursing, and the family contact on file gets an update if the resident has agreed to that.

Because the Riverbend covers several towns, start a call with the town and ZIP code, such as 62002 for Alton, 62035 for Godfrey, 62024 for East Alton, 62095 for Wood River or 62010 for Bethalto. Add a phone number, the care setting and the regular doctor, and mention that the address is in Illinois. Availability is confirmed town by town. Gateway also arranges care in Edwardsville and Granite City, which helps when relatives live elsewhere in Madison County.

  • 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 surgical site infections, 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 start wound follow-up in the Riverbend?

No. Patients, family members and caregivers can call Gateway directly, and surgical practices, hospitals and facilities can also refer. Once you call, we ask for the surgeon’s name and the hospital so the treating clinician can get the operative notes and current orders. Some health plans have their own referral or authorization rules, and those are checked along with your coverage before visits begin.

Is a surgical site infection contagious to the people I live with?

Ordinary contact such as sitting together or sharing a meal is generally not a concern. Bacteria can spread through direct contact with wound drainage or used dressings. The usual precautions are washing hands before and after touching the dressing, bagging used materials and not sharing towels. If the culture showed a resistant type of bacteria, or someone at home has a weak immune system, ask the treating clinician whether more steps are needed.

Should I keep my surgeon appointments if a wound clinician is already visiting?

Yes. Wound visits add to the surgeon’s care and do not replace it. The surgeon decides about antibiotics, further procedures, closing the wound and when you can return to normal activity. The treating clinician’s notes can make those appointments more productive, because the surgeon sees how the wound has changed since the last check. If getting to the office is the obstacle, tell us when you call.

My husband in the Riverbend has a leg ulcer that keeps coming back. Can Gateway help?

Call us and we will work on arranging a visit with a partner wound care clinician. Leg ulcers that return are often tied to circulation or swelling in the legs, and the treating clinician will assess the cause before deciding on treatment. Tell the clinician about earlier ulcers and what was tried. Report spreading redness, fever or sudden pain promptly.

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.