About surgical site infections

A surgical site infection is an infection that develops where a surgeon cut, in the days and weeks after an operation. Clinicians sort these infections by depth. Some stay in the skin and the fat just under the incision. Others reach the muscle layer and its covering. A third kind sits in the organ or space that was operated on, such as a joint or the abdomen. Depth matters because it shapes the treatment: a shallow infection may be handled by opening part of the incision and giving antibiotics, while a deep one can mean another procedure. Whatever the depth, the surgical team makes the diagnosis and directs treatment. Wound follow-up is what comes next, the regular checking and dressing of the incision while it recovers.

What the treating clinician looks at

The first visit starts with the story of the operation. The treating clinician wants to know what procedure was done and when, whether mesh, hardware or a joint implant was placed, and what the surgical team has done about the infection so far. That includes whether the incision was opened, whether a culture was taken, which antibiotic was prescribed and when it is due to end. Gateway requests the operative and discharge records so the clinician is not relying on memory alone. With that background, the clinician examines the wound and sets a dressing plan that fits the surgeon’s instructions.

Local context: Belleville, Illinois

Crossing a bridge for every wound check is a lot to ask of someone in Belleville with an open, draining incision. When the surgeon is in Missouri, home or facility visits on the Illinois side can reduce those trips, with the treating clinician’s findings sent to the surgeon between rechecks. Home health agencies and supply vendors also differ by state and by plan. Gateway confirms the treating provider and your coverage first, whether that is Illinois Medicaid or a Missouri-based plan, so dressing orders and any pump or equipment go through channels your plan recognizes.

Near downtown Belleville, brick houses and duplexes are set close to the street. The west and east ends have ranch homes and subdivisions, and apartment complexes line the main routes. The city also has senior apartments, assisted living, memory care, and skilled nursing and rehabilitation centers, as you would expect in a county seat. Gateway arranges visits from partner clinicians in each setting. In homes we schedule with the patient or caregiver. In facilities we set visit days with the nursing staff and share the clinician’s orders after each visit.

When care happens at home

Supplies are a common sticking point after a surgical site infection, because the dressings ordered for an open, draining wound are rarely what was sent home from the hospital. Gateway coordinates the clinician’s supply orders so the right materials come to the house, and follows up on refills as the wound’s needs change. It helps to pick one clean, dry spot for everything, away from pets and the bathroom floor, with a small trash bag for used dressings. If a negative pressure pump has been ordered, we coordinate the equipment and the canisters and dressings that go with it.

Care in skilled nursing and assisted living

Many people who develop a surgical site infection are already in a skilled nursing or rehabilitation center, recovering from a joint replacement, a hip repair or abdominal surgery. There, facility nurses change the dressing and take vital signs, and the attending physician oversees medical care. The treating wound clinician adds a focused wound exam at each visit, writes or recommends orders according to the facility’s process, and talks with the nurses who see the incision every day. Gateway arranges those visits with the facility and routes the clinician’s notes to the surgeon, so the three teams are reading the same record.

What to report and when to call 911

Some changes worth reporting come from the treatment, not the wound. Let the prescriber and the treating clinician know about:

  • Watery diarrhea, especially several times a day
  • A new rash, itching or hives
  • Vomiting that keeps you from taking the antibiotic
  • White patches in the mouth or other new irritation
  • Redness, warmth or drainage that returns after the antibiotic course ends

Report these promptly so the prescriber can decide what to do. Do not stop or restart a medicine on your own. Call 911 for swelling of the lips, tongue or throat, trouble breathing, or widespread hives with dizziness, which can signal a severe allergic reaction.

How primary care fits in

Blood sugar and infection push each other in the wrong direction. Infection and the stress of surgery tend to raise glucose, and high glucose makes it harder for white blood cells to do their work and for new tissue to form. People with diabetes often see their readings change during a surgical site infection, and some people learn they have diabetes only when an incision is slow to recover. A primary care clinician can review the readings and decide whether the diabetes plan needs attention during this period. Gateway can arrange primary care alongside wound visits, so the two clinicians share what they find.

Primary care at home in Belleville →

Arranging wound follow-up after a surgical site infection in Belleville

Setting up wound follow-up after a surgical site infection for someone in Belleville usually goes in this order:

  1. You call 314-325-0126 or send the request care form, which asks only for a name and phone number.
  2. Gateway talks with you about the wound, the address and the insurance.
  3. We confirm availability for that location and gather records for the treating clinician.
  4. The clinician visits, assesses the wound and writes the orders.
  5. We follow up on supplies, the next visit and communication with your other clinicians.

You do not need a confirmed diagnosis to start.

Belleville has four main ZIP codes, 62220, 62221, 62223 and 62226, so the ZIP code tells us a lot about where in the city a home is. Give it along with the street address, a phone number, the care setting and the insurance plan, and say so if the plan is an Illinois one. Availability is confirmed by location. Gateway also arranges care in Fairview Heights, O’Fallon, Collinsville and across St. Clair County and the Metro East.

  • County: St. Clair County, Illinois
  • ZIP codes: 62220, 62221, 62223, 62226
  • Nearby hospitals: Memorial Hospital Belleville; Memorial Hospital Shiloh; HSHS St. Elizabeth's Hospital in O'Fallon, Illinois (not affiliated with Gateway)
  • Nearby communities: Fairview Heights, O'Fallon, Illinois, St. Clair County, Illinois, Collinsville, Metro East
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Related care in Belleville

Read the full guide to surgical site infections, or see everything Gateway arranges on the mobile wound care in Belleville page.

Common questions

Does Gateway arrange surgical site infection follow-up in nursing and rehabilitation facilities in Belleville?

Gateway arranges wound visits in skilled nursing facilities, rehabilitation centers, assisted living and memory care, as well as private homes. In a facility, the treating clinician works with the nursing staff and the attending physician under the facility’s own procedures. Facility staff or family can contact us to ask whether a partner clinician is available at a particular building in Belleville.

What is negative pressure wound therapy, and why might it be ordered?

It is a treatment in which a sealed dressing is connected to a small pump that applies gentle suction to an open wound. The suction draws fluid away and can help some wounds fill in. A surgeon or treating clinician may order it for a deep or heavily draining surgical wound once infection is under control. It is not right for every wound, and the ordering clinician decides.

What happens when the infection is near a joint replacement, mesh or other hardware?

Infection around implanted material is more serious, because bacteria can cling to surfaces that the body’s defenses and antibiotics reach poorly. The surgical team decides how to manage it, which may involve longer antibiotic treatment, a procedure to wash out the area, or removing or replacing the implant. Wound follow-up in this situation centers on close observation and prompt reporting, so the surgeon hears early about any drainage, opening or new pain.

Does Gateway arrange care for diabetic foot wounds in Belleville?

Yes. Partner wound care clinicians see diabetic foot ulcers at home and in facilities. The treating clinician assesses the wound and the circulation, decides on treatment and may involve other specialists. Between visits, report new redness, swelling, drainage, odor, a color change in the toes or fever. A foot wound in a person with diabetes should not be left to wait.

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.