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 the treating clinician looks at

The wound is only part of the assessment. The treating clinician also asks about pain, appetite, bowel changes since the antibiotic began, and how well you are moving around. Temperature and pulse are noted. If the incision is on the abdomen, the clinician considers strain from coughing or lifting. If it is on a leg, swelling and circulation get attention. The clinician then decides who should hear about what, such as the surgeon for a suspected deep pocket or the primary care clinician for poor eating and drinking. The plan names what will be checked at each visit and what result would prompt a call.

Wound follow-up after a surgical site infection in Fairview Heights

People in Fairview Heights 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.

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.

When care happens at home

Recovering from an operation at home already means lifting limits, less driving and a body that tires quickly. An infection adds surgeon rechecks, sometimes lab work, and a wound that has to stay dressed. Bringing wound visits to the house removes some of those trips. For appointments that still have to happen in person, such as a recheck with the surgeon, Gateway can help with transportation arrangements and send the latest wound notes to the office beforehand. If home health is already coming for therapy or nursing, we coordinate so the wound orders reach that agency and the two schedules do not collide.

For residents of nursing and senior living communities

In a rehabilitation setting, an infected incision has to share the day with therapy. Dressing changes work best when they are timed so a leaking or painful wound does not cut a session short, and therapists need to know about any movement limits the surgeon has set. Some residents are also receiving intravenous antibiotics through a long-term line, which facility nurses manage under the prescriber’s orders. The treating clinician watches how the wound responds and tells the attending physician and surgeon what it shows. Gateway helps keep track of the dates that matter, including antibiotic end dates, surgeon rechecks and the planned discharge.

Changes to report

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.

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.

Primary care at home in Fairview Heights →

How to get started in Fairview Heights

Setting up wound follow-up after a surgical site infection for someone in Fairview Heights 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.

For a Fairview Heights request, it helps to have the street address and unit number, the ZIP code (62208), any gate or entry instructions, the patient’s insurance card and a list of current medications. Gateway also arranges care in O’Fallon, Belleville, Collinsville and the rest of St. Clair County, which is useful when family members live in different towns. Scheduling depends on the care setting and location, and we confirm availability before setting a visit.

  • 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 surgical site infections, 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 start wound follow-up in Fairview Heights?

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.

Should I keep my surgeon appointments if a wound clinician is already visiting?

Yes. Wound visits add to the surgeon’s care and do not replace it. The surgeon decides about antibiotics, further procedures, closing the wound and when you can return to normal activity. The treating clinician’s notes can make those appointments more productive, because the surgeon sees how the wound has changed since the last check. If getting to the office is the obstacle, tell us when you call.

How long will an infected surgical wound take to close?

No one can give an exact date. It depends on how deep and wide the opened area is, whether the infection is fully controlled, where on the body it sits, and your general health. A better question for the treating clinician is whether the wound is moving in the right direction: smaller measurements, less drainage and healthy tissue at the base from one visit to the next.

I no longer drive. Can Gateway help me get from Fairview Heights to an outpatient appointment?

Gateway can help with transportation arrangements when the treating clinician recommends a visit in an outpatient or office setting, such as a test or a specialist appointment. Tell us about any mobility needs, such as a wheelchair or help with steps. What is available depends on your location, your plan and the type of appointment, so we go over the details with you beforehand.

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.