What to know about surgical site infections
The course of a surgical site infection usually has two parts. The first is short and intense: the incision becomes painful, red and swollen, often some days after you thought the hard part was over, and the surgical team steps in. The second part is slower. Once the infection is controlled, an incision that was opened has to fill with new tissue from its base upward, and that work goes on well after the last antibiotic dose. Drainage normally lessens, the wound gets shallower and the edges draw inward. Progress is not always even. A wound can stall, or a pocket can form under skin that looks closed. Some wounds are stitched shut later by the surgeon once they are clean.
What an assessment covers
At the bedside, the treating clinician builds a baseline that later visits are compared against. Typical parts of the exam include:
- Length, width and depth of any open area
- Tunnels or pockets under the skin edges
- The color and type of tissue in the wound bed
- How much drainage there is and what it looks like
- The surrounding skin and any remaining stitches or staples
Each finding is recorded the same way every time, so a small change in size or a new pocket stands out. The care plan follows from what the exam shows and what the surgeon has ordered.
Wound follow-up after a surgical site infection in Clayton and Central County
With skilled nursing facilities and senior living communities close by, people in Clayton and Central County often spend the first weeks after an operation in rehabilitation and then return to a house they have lived in for decades. A surgical site infection can show up on either side of that move. Gateway arranges wound follow-up in the facility and at home, and carries the dressing orders, measurements and antibiotic dates across the transfer. Neighbors and adult children who help out can ask the clinician what a worrying dressing looks like.
You will find nearly every kind of home in Clayton and Central County: high-rise condos with a front desk, older brick apartment buildings without elevators, two-story houses, duplexes and bungalows in the inner suburbs. Senior living is well represented too, from independent apartments to assisted living, memory care and skilled nursing and rehabilitation. Gateway arranges partner clinician visits in each setting. We ask about elevators, entry and parking for apartment and condo visits, and we work with facility nurses on timing so a visit does not collide with therapy or meals.
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.
For residents of nursing and senior living communities
A common point where things slip for an infected surgical wound is the move out of a facility. Orders that were followed on every shift have to be handed to a family, a home health agency or another facility, and details go missing. Before discharge, Gateway works with the facility’s nurses and discharge planner to gather the current dressing orders, the most recent wound measurements, the antibiotic plan and the date of the next surgeon visit. Where availability allows, wound visits continue at the new address, so the person checking the wound already knows what it looked like the week before.
Signs to tell the clinician about
Between visits, the dressing and the skin around it tell you a lot. Contact the treating clinician or the surgeon’s office if you notice:
- Redness or darkening of the skin that extends past where it was yesterday
- Drainage that soaks through sooner than it used to
- Fluid that turns thick, cloudy or foul smelling
- Skin edges that pull farther apart
- A firm, tender or soft, swollen lump beside the incision
Call 911 for heavy bleeding that does not stop with firm pressure, if tissue from inside the body bulges through an open abdominal wound, or if the person becomes confused, faint or very short of breath.
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.
How to get started in Clayton and Central County
For a resident of a nursing home, assisted living or memory care community in Clayton and Central County, 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.
Here is what helps when arranging care in Clayton and Central County. Know the municipality and ZIP code, such as 63105 in Clayton, 63117 in Richmond Heights or 63124 in Ladue, because several main roads run through more than one town. Tell us about building access and where a visitor can park. Name one family contact for scheduling calls. Weekday traffic and parking around downtown Clayton can shape the visit window. Gateway also arranges care in Brentwood, Maplewood, University City and the Central West End.
- County: St. Louis County, Missouri
- ZIP codes: 63105, 63117, 63124
- Nearby hospitals: SSM Health St. Mary's Hospital in Richmond Heights; Barnes-Jewish Hospital; Missouri Baptist Medical Center in Town and Country (not affiliated with Gateway)
- Nearby communities: Richmond Heights, University City, Ladue, Brentwood, Maplewood, Central West End
- Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation
Related care in Clayton and Central County
Read the full guide to surgical site infections, or see everything Gateway arranges on the mobile wound care in Clayton and Central County page.
- Diabetic foot ulcers
- Venous leg ulcers
- Pressure injuries and bed sores
- Arterial and mixed wounds
- Non-healing wounds
- Post-surgical wounds
- Reopened (dehisced) surgical wounds
- Skin tears and traumatic wounds
- Wounds with lymphedema
- Skin graft aftercare
- Wound VAC (NPWT) follow-up
- Wound follow-up after a surgical site infection in University City
- Wound follow-up after a surgical site infection in Ladue
- Wound follow-up after a surgical site infection in the Central West End
Common questions
Does Gateway arrange surgical site infection follow-up in nursing and rehabilitation facilities in Clayton and Central County?
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 Clayton and Central County.
Will my insurance pay for wound follow-up visits in Clayton and Central 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.
Do I need a referral from my surgeon to start wound follow-up in Clayton and Central County?
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.
My wife is leaving SSM Health St. Mary’s Hospital for our home in Clayton and Central County. When should we ask about follow-up?
Ask as early as you can, ideally before she leaves the hospital. Early notice gives Gateway time to request her records and check availability for your address. We cannot promise a specific day, because timing depends on location and care setting. Until a visit happens, follow the hospital’s discharge instructions, and call 911 for heavy bleeding, chest pain, trouble breathing or sudden confusion.
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.