About surgical site infections

Every incision breaks the skin, the body’s main barrier against bacteria. Surgical teams lower the risk with skin cleansing, sterile technique and, for many operations, an antibiotic given shortly before the first cut. Even so, some bacteria reach the wound, most often from the patient’s own skin or, in bowel surgery, from the gut. Whether they take hold depends on how many there are and how well the tissue can defend itself. Tissue with poor blood flow, a collection of blood or fluid under the skin, or foreign material such as mesh gives bacteria a place to settle. Careful practice lowers the risk but cannot remove it, which is why the first weeks after any operation call for a close eye on the incision.

What an assessment covers

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.

Wound follow-up after a surgical site infection in Chesterfield and West County

From Chesterfield and West County, the surgeon’s office and the hospital where the operation took place can be a long drive, and sitting in a car is uncomfortable with a sore, draining incision. Wound follow-up at home reduces how often that drive is needed. Many family caregivers here commute, so a daytime dressing change may fall when no one else is in the house. Tell us who is home and when. Gateway works with the treating clinician and, if ordered, home health to plan for the changes a working family cannot do.

Chesterfield and West County have a wide range of places to live as people age. Many residents stay in the two-story houses where they raised families. Others move to ranch villas, condominiums, independent living apartments or senior communities with assisted living, memory care and skilled nursing on one campus. Gateway arranges visits from partner clinicians across this range. When a resident moves from one level of care to another, we update the address, the facility contacts and the records so the treating clinician’s plan follows the person.

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.

For residents of nursing and senior living communities

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.

Changes to report

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.

Why primary care matters here

A new antibiotic joins whatever else you take, and the combination deserves a look. Some antibiotics change how other medicines act, blood thinners among them, and some are cleared by the kidneys, which matters for older adults. Pain medicine after surgery can cause constipation and drowsiness, and steroids or other immune-suppressing drugs can slow wound healing. Sorting this out is primary care work. A primary care clinician can review the full list, including what the hospital added or stopped, and raise concerns with the surgeon or prescriber. When Gateway arranges both kinds of care, the wound clinician’s findings reach the clinician reviewing the medicines.

Primary care at home in Chesterfield and West County →

Arranging wound follow-up after a surgical site infection in Chesterfield and West County

People asking about wound follow-up after a surgical site infection in Chesterfield and West County usually want to know what the first visit involves. Before it, Gateway collects the records the treating clinician asks for and confirms the time and place with you. During it, the clinician looks at the wound and the skin around it, measures it, asks about your health and medications and explains what they recommend. Afterward, the orders go to whoever does the daily care, supplies are requested and a follow-up is planned. Our guide to how mobile wound care visits work has more. To begin, call 314-325-0126. Whether a visit can be arranged is confirmed for your location.

When you call, it helps to know the subdivision or community name as well as the street address, since some neighborhoods are gated and many streets end in cul-de-sacs. Tell us about gate codes, long driveways and which entrance a facility prefers for visitors. Have the patient’s doctor and pharmacy names handy. Gateway also arranges care in Ballwin, Wildwood, Creve Coeur, Maryland Heights, Ellisville and Des Peres, and visits in Chesterfield and West County are planned with those neighboring areas in mind. Availability is confirmed by location and setting.

  • County: St. Louis County, Missouri
  • ZIP codes: 63017, 63005
  • Nearby hospitals: St. Luke's Hospital in Chesterfield; Mercy Hospital St. Louis in Creve Coeur; Missouri Baptist Medical Center in Town and Country; Barnes-Jewish West County Hospital in Creve Coeur (not affiliated with Gateway)
  • Nearby communities: Chesterfield, Ballwin, Wildwood, Ellisville, Des Peres, Creve Coeur
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Related care in Chesterfield and West County

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

Common questions

Will my insurance pay for wound follow-up visits in Chesterfield and West County after a surgical site infection?

That depends on your plan, the treating provider and the care that is needed. You can ask us about Medicare, Medicare Advantage, Medicaid and commercial plans, and we help confirm participation and benefits with the treating practice before care starts. Have your insurance card nearby when you call. Decisions about what is paid for rest with your plan, not with Gateway.

How long will an infected surgical wound take to close?

No one can give an exact date. It depends on how deep and wide the opened area is, whether the infection is fully controlled, where on the body it sits, and your general health. A better question for the treating clinician is whether the wound is moving in the right direction: smaller measurements, less drainage and healthy tissue at the base from one visit to the next.

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.

Are homes in the western part of Chesterfield and West County, out along Wild Horse Creek Road, too far for visits?

They are within the area where Gateway arranges care. The western part of Chesterfield has longer drives between homes, so visits there may be grouped on particular days. Tell us the address and any details about gates or private roads. We confirm availability for the location and care setting, and we will tell you plainly if a visit cannot be arranged where you are.

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.