What to know about post-surgical wounds

Any operation carries some chance of a wound problem, but certain people and procedures call for closer watching. Older adults, people with diabetes or vascular disease, people who smoke, and those who were underweight or carrying extra weight at the time of surgery are more likely to heal slowly. So are people who had emergency surgery, a long operation, bowel surgery, an amputation, or a second procedure through an old scar. People who take steroids or medicines that quiet the immune system, and people who have trouble moving, eating or keeping the area clean after discharge, belong on the same list. None of this means a problem will happen. It means the incision deserves regular, careful follow-up.

What the treating clinician looks at

Beyond the incision, the treating clinician looks at the person. Is pain controlled well enough to move, cough and sleep? Is the patient eating and drinking enough, and has weight dropped since the operation? Are the lifting and movement limits being followed, or are they too hard to keep at home? Can the patient reach the wound, or does someone else need to do dressing changes? Is there swelling in a leg, a binder that rubs, or a brace that presses on the incision line? The answers shape the plan as much as the wound’s appearance does, and they often point to something the surgeon or another member of the care team needs to hear about.

Local context: Madison County, Illinois

Post-surgical follow-up for patients in Madison County often involves a Missouri surgeon, an Illinois home health agency and an Illinois health plan, each with its own rules about orders, supplies and authorizations. Gateway sorts out the treating provider and coverage questions first, because participation and benefits depend on the provider, the plan and the care needed. Then we coordinate dressing supplies and visit notes across the river. When the surgeon wants to see the incision in person, we can help arrange transportation so the bridge crossing is not what delays the appointment.

Across Madison County you will find older houses on city lots, newer subdivisions, farmhouses and apartments, along with independent and assisted living, memory care, rehabilitation centers and skilled nursing facilities in the larger towns. Gateway arranges wound care and primary care visits with partner clinicians in each of these settings. The steps differ a little from one to the next. At home, we plan around the household and whoever helps with care. In a facility, we plan around the staff, the chart and the resident’s daily routine.

Care at home

Many people go home after surgery with a home health agency already assigned. In that case the home health nurse usually handles routine dressing changes, and the treating clinician arranged through Gateway adds wound-focused assessments and orders. We make sure both are reading the same instructions, since two sets of dressing orders in one house is a common source of mistakes. If no agency is involved, the clinician decides who can safely change the dressing, which may be you, a family member or a nurse, and Gateway follows up on whatever that plan requires.

Care in skilled nursing and assisted living

In rehabilitation, the wound and the therapy schedule have to work together. A new knee or hip incision is bent and loaded several times a day, and an abdominal incision is strained each time a patient is helped out of bed. The treating clinician shares findings with nursing and therapy so that a draining or separating incision is noticed by the people who see it most, and so that questions about movement limits go to the surgeon instead of being guessed at. Gateway schedules visits around therapy sessions where possible and routes updates to the attending physician.

What to report and when to call 911

Report these changes to the surgeon’s office or the treating clinician without waiting for the next visit:

  • Redness that widens around the incision or streaks away from it
  • Drainage that becomes thicker, cloudy or foul-smelling
  • A gap opening between the edges
  • Fever, chills or feeling newly unwell
  • Pain that climbs after it had been easing

Call 911 if the incision bursts open and deeper tissue or an organ is visible, if bleeding will not stop with steady pressure, or if chest pain, shortness of breath, fainting or sudden confusion develops.

How primary care fits in

Surgery stresses the body, and blood sugar often runs higher than usual in the weeks afterward, even in people whose diabetes was steady before. High readings slow tissue repair and make infection more likely. The surgeon manages the operation, but day-to-day glucose monitoring and diabetes medicines usually belong to primary care. When Gateway arranges both wound follow-up and primary care, the clinician watching the incision and the clinician managing blood sugar can share what they see, so a stalled wound and a run of high readings are looked at together instead of weeks apart.

Primary care at home in Madison County →

How to get started in Madison County

Setting up post-surgical wound care for someone in Madison County 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.

Madison County patients are discharged from several hospitals: Anderson Hospital in Maryville, Alton Memorial Hospital, OSF Saint Anthony’s Health Center in Alton, Gateway Regional Medical Center in Granite City and HSHS St. Joseph’s Hospital in Highland. Gateway Wound Care is not affiliated with any of them, and follow-up can be requested no matter where the stay took place. A family member or discharge planner tells us where the patient is headed, whether home or a facility. We then obtain the discharge orders and arrange a visit with a partner clinician once availability for that location is confirmed.

  • County: Madison County, Illinois
  • ZIP codes: 62025, 62034, 62234, 62040, 62002, 62035
  • Nearby hospitals: Anderson Hospital in Maryville; Alton Memorial Hospital; OSF Saint Anthony's Health Center in Alton; Gateway Regional Medical Center in Granite City; HSHS St. Joseph's Hospital in Highland (not affiliated with Gateway)
  • Nearby communities: Edwardsville, Glen Carbon, Collinsville, Granite City, Alton, Godfrey, Illinois
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Related care in Madison County

Read the full guide to post-surgical wounds, or see everything Gateway arranges on the mobile wound care in Madison County page.

Common questions

Do I need a referral from my surgeon to arrange wound follow-up in Madison County?

No. Patients, family members and caregivers can call Gateway directly, and surgical offices and discharge planners can refer as well. Once you call, we ask for permission to request the operative report and discharge instructions, because the treating clinician needs the surgeon’s orders before making decisions about the incision. Some health plans have their own referral rules, which we help you check.

Why does my incision itch, feel numb or have a hard ridge under it?

Itching, patches of numbness and a firm ridge beneath the scar are common as an incision heals, because small nerves were cut and new tissue is forming. They usually ease gradually. Mention them at your next visit. Report them sooner if itching comes with a rash or blisters under the dressing, or if the firm area becomes larger, red, hot or painful.

How long does a surgical wound take to heal?

There is no single answer, and no one can promise a date. It depends on the operation, how the incision was closed, where it is on the body and your general health. A wound left open to heal from the base takes longer than a closed incision. Your surgeon and the treating clinician can tell you what progress to expect at each stage in your situation.

Can I request primary care at home in Madison County if I do not have a wound?

Yes. Wound care and primary care can be arranged separately or together, depending on what the patient needs. A request can be for follow-up of ongoing conditions such as diabetes, heart disease or memory loss, or for follow-up after a hospital stay, with no wound involved. The treating clinician determines what care is appropriate, and availability is confirmed for your town and care setting.

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.