Care for a reopened surgical wound in Creve Coeur.

About reopened surgical wounds

Any operation can end with a reopened incision, but some people carry more risk than others. Wounds tend to knit more slowly in people living with diabetes, poor circulation, kidney disease or a weakened immune system, and in people who smoke. Extra body weight puts more pull on an abdominal closure and leaves a thicker fatty layer, which has a limited blood supply. Older adults with thin skin, people who were eating poorly before surgery, and people taking steroids long term are also more likely to have trouble. So are those whose operation was an emergency, ran long, or went through an old scar. None of this means dehiscence is certain. It tells the care team whom to watch closely.

How the care plan is built

The care plan for a dehisced incision answers a few practical questions. What goes in and over the wound, and how often is it changed? Who changes it on the days between clinician visits? What activity limits did the surgeon set, and do they still apply? The treating clinician picks dressings to match the drainage and depth, and revises the choice as the wound fills in. For a deep or heavily draining wound, the clinician may order negative pressure wound therapy, which is a sealed dressing attached to a small pump. The plan also spells out which findings would send the patient back to the surgeon sooner than planned.

Arranging this care in Creve Coeur

People in Creve Coeur who have a joint replacement or major abdominal surgery often spend a stretch in a nearby skilled nursing or rehabilitation center before returning home. A dehisced wound has to be followed across that move. Gateway coordinates so that the measurements, current dressing orders and the surgeon’s instructions go with the patient from the facility to the house, or from an independent apartment in a senior living community to its care wing. Supplies are a frequent gap on the day of discharge, so we confirm what is being sent home and what still needs to be ordered.

Creve Coeur sits where Olive Boulevard meets Interstate 270, a West County city that mixes medical offices and corporate campuses with established neighborhoods. Lindbergh Boulevard runs along its eastern side, and New Ballas Road runs north to south through the middle. Because two hospitals and many physician offices are inside the city limits, it is easy to assume care is always within reach. Yet a person with a slow-healing wound, a walker and no driver may find a one-mile trip as hard as a ten-mile one. Bringing care to the home or facility removes that trip.

At home between visits

Many people come home from surgery with a home health agency already in place. When an incision opens, Gateway coordinates the wound care visits with that agency so the nurse and the treating clinician are following one set of orders, not two. If the clinician orders a wound therapy device, the agency nurse typically handles its scheduled dressing changes, and we help with the paperwork and delivery arrangements for the pump and its supplies. If no agency is involved and the wound needs skilled dressing changes several times a week, the treating clinician can decide whether a home health referral makes sense.

For residents of nursing and senior living communities

Assisted living communities differ in how much nursing care they can provide, and an open surgical wound can test those limits. Some have a nurse who can change a dressing daily. Others rely on a home health agency coming in. When a resident’s incision opens, Gateway asks the community what its staff can and cannot do, then arranges the treating clinician’s visits and any outside nursing around that answer. Aides who help with bathing and dressing need the basics from the clinician’s orders as well: how the dressing is protected during a shower, how to avoid pulling on the area during transfers, and whom to tell if it is soaked or loose.

What to report and when to call 911

A reopened incision should look a little better, or at least no worse, each time the dressing comes off. Tell the treating clinician or the surgeon’s office promptly if you notice:

• The gap growing longer, wider or deeper
• Thick, cloudy or foul-smelling drainage
• Redness that is spreading outward from the edges
• A fever, chills or a new sense of being ill
• Stitches, staples or mesh showing that were not visible before

Call 911 if an abdominal incision bursts open, if anything bulges out through the wound, if bleeding will not stop, or if you have chest pain or trouble breathing.

Primary care and overall health

Closing an open surgical wound takes raw material. The body needs enough protein, calories and fluid to lay down new tissue, and appetite is often poor after an operation, especially in older adults. A primary care clinician can look at weight changes, check for problems such as trouble chewing or swallowing, nausea or low mood, and decide whether lab work or a nutrition referral is warranted. Wound drainage itself carries protein out of the body, which adds to the need. Ask before starting supplements, since the right choice depends on kidney function, diabetes and the medicines you take. Arranging wound care and primary care together lets both clinicians work from the same picture.

Primary care at home in Creve Coeur →

How to get started in Creve Coeur

To arrange care for a reopened surgical wound in Creve Coeur, call Gateway at 314-325-0126. Patients, family members and caregivers can call directly, and a referral is not required. We will ask where the patient lives, what has been done for the wound so far and which clinicians are involved. Gateway then confirms whether a partner clinician is available for that address and care setting, requests the relevant records and schedules the visit. At that visit the treating clinician examines the wound and decides on the plan. Our job from then on is the coordination: orders, supplies, follow-up visits and keeping the care team informed.

To arrange care in Creve Coeur, start with the basics: the patient’s full name, the address in 63141, a callback number and the name of the primary care physician. If the person lives in a senior community, add the apartment number and the nurse’s station phone. Because Creve Coeur sits at the junction of Olive Boulevard and Interstate 270, visits can be planned along with Maryland Heights, Ladue, Overland, Des Peres, University City and Chesterfield. Let us know about days that will not work, such as dialysis or therapy days.

• County: St. Louis County, Missouri
• ZIP codes: 63141
• Nearby hospitals: Mercy Hospital St. Louis in Creve Coeur; Barnes-Jewish West County Hospital in Creve Coeur; Missouri Baptist Medical Center in Town and Country (not affiliated with Gateway)
• Nearby communities: Chesterfield, Maryland Heights, Chesterfield and West County, Ladue, Overland, Des Peres
• Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

More wound care in Creve Coeur

Read the full guide to reopened surgical wounds, or see everything Gateway arranges on the mobile wound care in Creve Coeur page.

• Diabetic foot ulcers
• Venous leg ulcers
• Pressure injuries and bed sores
• Arterial and mixed wounds
• Non-healing wounds
• Post-surgical wounds
• Surgical site infections
• Skin tears and traumatic wounds
• Wounds with lymphedema
• Skin graft aftercare
• Wound VAC (NPWT) follow-up
• Care for a reopened surgical wound in Maryland Heights
• Care for a reopened surgical wound in Chesterfield and West County
• Care for a reopened surgical wound in Ladue

Common questions