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: Fairview Heights

Post-surgical follow-up for patients in Fairview Heights 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.

Much of Fairview Heights is made up of ranch and split-level houses in established subdivisions, with apartment and condominium complexes near the main roads. Senior apartments, assisted living and nursing care are found in and around the city as well. Gateway arranges visits with partner clinicians in any of these places. For an apartment, we ask about building entry and parking so the visiting clinician can reach the door. For a facility, we coordinate with the nurse on duty about timing and the resident’s records.

Care at home

Supplies are where home recovery often goes wrong. The hospital sends you home with a few days of dressings, and then the gauze, tape or drain supplies run out over a weekend. Once the treating clinician writes an order, Gateway follows up with the supplier so the right items in the right sizes arrive before they are needed, and we check again when the order changes. If a negative pressure device is part of the plan, we help coordinate delivery, canister and dressing-kit resupply, and the question of who changes it.

In a facility

A resident with dementia may not remember having surgery, may pull at a dressing or pick at staples, and may not be able to say that an incision hurts. In memory care, the treating clinician relies on staff observations and plans for these realities, for example with a dressing that is harder to remove and clothing that covers the site. Staff are told which behaviors, such as new restlessness, guarding one side or refusing to walk, might signal a wound problem. Gateway keeps the family or legal representative updated and sends findings to the attending physician and the surgeon.

Changes to report

For a caregiver, the first hint of a wound problem is often the person, not the incision. Tell the treating clinician if you notice:

  • A temperature above the level named in the discharge papers
  • New tiredness, poor appetite or nausea
  • Swelling, hardness or a bulge beside the incision
  • A new smell when the dressing comes off
  • Skin around the tape turning red, blistered or raw

Call 911 right away for sudden confusion, fainting, a racing heartbeat with shaking chills, difficulty breathing, chest pain, or a wound that has split open or is bleeding heavily.

How primary care fits in

Recovery after surgery depends on conditions that existed long before the operation. Heart, lung and kidney disease affect swelling and oxygen delivery. Poor circulation in the legs slows healing of incisions below the knee. Tobacco use narrows small blood vessels. Limited mobility raises the risk of blood clots, pneumonia and pressure injuries during weeks of reduced activity. A primary care clinician keeps those conditions managed while the surgeon and the wound care clinician focus on the incision. Gateway can arrange both kinds of visits so the person, not only the wound, is followed through recovery.

Primary care at home in Fairview Heights →

How to get started in Fairview Heights

If you have been managing a wound mostly on your own and are looking for post-surgical wound care in Fairview Heights, you can call Gateway yourself at 314-325-0126. Tell us what the wound looks like now, what the last clinician said about it and what is getting harder to manage. It helps to know the patient’s insurance and the names of the doctors involved, but do not wait until you have everything. We check whether a partner clinician can see the patient at home or in their facility, and we tell you what we find. The treating clinician takes it from there, and you stay part of the conversation.

People in Fairview Heights have three hospitals within a short drive: HSHS St. Elizabeth’s Hospital in O’Fallon, Illinois, Memorial Hospital Shiloh and Memorial Hospital Belleville. Gateway has no affiliation with them. If you are a family member, you can call while your relative is still admitted and tell us the planned discharge date and destination. If you are a discharge planner, a phone call or fax starts the referral. From there, Gateway requests the discharge instructions, shares them with the treating clinician and arranges follow-up for wound care, primary care or both.

  • County: St. Clair County, Illinois
  • ZIP codes: 62208
  • Nearby hospitals: HSHS St. Elizabeth's Hospital in O'Fallon, Illinois; Memorial Hospital Belleville; Memorial Hospital Shiloh (not affiliated with Gateway)
  • Nearby communities: O'Fallon, Illinois, Belleville, Illinois, Collinsville, St. Clair County, Illinois
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

More wound care in Fairview Heights

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

Common questions

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

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.

What should I have ready for the first wound visit after surgery?

Gather the discharge papers, the list of medications you are taking now, any dressing supplies the hospital sent home, and the date of your next surgeon appointment. If you track drain output or temperature, keep that log handy. It also helps to write down when the dressing was last changed and any changes you have noticed since leaving the hospital.

The incision opened a little at one end. Is that an emergency?

A small, shallow gap with little drainage is usually not an emergency, but report it to the surgeon’s office or the treating clinician promptly so someone can look at it. Keep it covered the way your discharge instructions describe, and do not try to close it yourself. Call 911 if the wound opens widely, if you can see deep tissue, or if bleeding does not stop with firm pressure.

I came home to Fairview Heights from the hospital with wound care instructions. What does Gateway do with them?

We ask for a copy of the discharge instructions and any orders, and pass them to the treating clinician before the visit. The clinician assesses the wound, reviews the hospital’s plan and decides whether to continue or change it. Until then, follow the instructions you were given and call the hospital or your doctor with questions. Report increasing pain, redness, swelling, drainage or fever promptly.

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.