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

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.

Arranging this care in Collinsville

People in Collinsville 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.

Homes in Collinsville range from older frame houses and brick bungalows near Main Street to ranch homes, newer subdivisions and apartment complexes closer to the interstates. Senior apartments, assisted living and skilled nursing care are part of the city too. Gateway arranges visits in each of these settings with partner clinicians. In a private home, we work out timing with the patient or a family member. In a facility, we coordinate with the nursing staff so the treating clinician has the chart, the current orders and a good time to see the resident.

Care at home

Home visits for an infected surgical wound are set at intervals the treating clinician chooses, and they often become less frequent as the wound settles. At each visit the clinician removes the dressing, examines and measures the wound, and redresses it. The dressing changes that fall between visits are done as ordered by a home health nurse, a caregiver who has been shown how, or you. Gateway schedules the visits, confirms the address and any access details, and sends the clinician’s update to the surgeon’s office, so your surgeon knows how the wound looks without waiting for your next appointment.

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.

What to report and when to call 911

Caregivers of older adults should know that infection does not always announce itself with fever. In a person who is frail or has dementia, report any of these to the treating clinician:

  • New confusion, restlessness or sleepiness
  • Refusing food or fluids
  • Guarding the surgical area or crying out when it is touched
  • A dressing that is suddenly wet, stained or strong smelling
  • A new fall or sudden weakness

After surgery on a leg or hip, also report new calf pain or swelling. Call 911 for chest pain, severe shortness of breath, a person who cannot be roused, or bleeding that will not stop.

Primary care and overall health

Surgeons follow a patient for a set period after an operation. Primary care stays on. That longer view matters when a surgical site infection is only one of several things going on: leg swelling from heart or vein problems around a lower-limb incision, poor circulation, a chronic cough that strains an abdominal wound, or weakness that keeps someone in bed and at risk for pressure injuries. A primary care clinician manages those conditions and coordinates with the surgeon about activity. For people who cannot easily get to an office, Gateway can arrange primary care visits in the same setting as the wound visits.

Primary care at home in Collinsville →

How to get started in Collinsville

People asking about wound follow-up after a surgical site infection in Collinsville 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 314-325-0126 about care in Collinsville, have the street address and ZIP code (62234), a phone number, the name of the patient’s regular doctor and any discharge papers within reach. Tell us whether the patient lives in a house, an apartment or a facility. Gateway also arranges care in Glen Carbon, Edwardsville, Granite City, Fairview Heights and Belleville, so relatives in neighboring towns can be discussed in the same call. Visit availability depends on the location and care setting, and we confirm it before anything is scheduled.

  • County: Madison County, Illinois
  • ZIP codes: 62234
  • Nearby hospitals: Anderson Hospital in Maryville; HSHS St. Elizabeth's Hospital in O'Fallon, Illinois; Gateway Regional Medical Center in Granite City (not affiliated with Gateway)
  • Nearby communities: Glen Carbon, Fairview Heights, Edwardsville, Granite City, Belleville, Illinois
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Other conditions and nearby communities

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

Common questions

Can a clinician come to a home in Collinsville to check an infected surgical incision?

Gateway arranges home visits from partner clinicians for wound follow-up after a surgical site infection. Whether a visit can be set up at an address in Collinsville depends on location and care setting, which we confirm when you call 314-325-0126. Gateway is not an emergency service. If your surgeon told you to go to the emergency department for certain symptoms, follow that instruction.

Can I shower with an open surgical wound?

Follow the surgical team’s instructions, because the answer differs by operation, by wound and by dressing. Some people are cleared to shower with the wound covered or uncovered. Others are asked to keep the area dry. Soaking in a bath, hot tub or pool is generally off limits until the surgeon says otherwise. If you were not told, ask before your next dressing change, and ask what to do if the dressing gets wet.

What does a wound culture tell the care team?

A culture is a sample from the wound sent to a laboratory to identify which bacteria are growing and which antibiotics work against them. Results usually take a few days. The prescriber may keep the first antibiotic or switch based on the report. A culture is read together with how the wound looks, because bacteria can be found on wounds that are not infected.

I work during the day. Can Gateway keep me updated about my father’s visits in Collinsville?

Yes, with your father’s agreement. Tell us who the family contact is and how to reach you during the day. Gateway coordinates communication among the care team, which includes passing along visit timing, follow-up needs and questions for the treating clinician. Clinical questions about the wound or a medication are answered by the treating clinician, and we help get those questions to the right person.

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.