What to know about surgical site infections

Several common beliefs about infected incisions cause trouble. One is that an infection means the surgery failed or that someone was careless, when it is a recognized risk of any operation. Another is that the problem ends with the antibiotic prescription. The medicine fights bacteria, but it does not close a wound that had to be opened. People are also alarmed when the surgeon leaves the incision open, though that is usually deliberate. And many assume a wound that looks better on the surface is finished, when a deeper pocket may still be draining. The most useful habit is to describe exactly what you see to the clinician, without deciding first whether it is good or bad.

What the treating clinician looks at

At the bedside, the treating clinician builds a baseline that later visits are compared against. Typical parts of the exam include:

  • Length, width and depth of any open area
  • Tunnels or pockets under the skin edges
  • The color and type of tissue in the wound bed
  • How much drainage there is and what it looks like
  • The surrounding skin and any remaining stitches or staples

Each finding is recorded the same way every time, so a small change in size or a new pocket stands out. The care plan follows from what the exam shows and what the surgeon has ordered.

Wound follow-up after a surgical site infection in Ferguson

Many homes in Ferguson are older single-family houses with the bedroom and full bath upstairs, which matters after surgery. A person with an infected abdominal or hip incision may be living on the first floor for a while, and the dressing supplies, good light and a firm chair need to be there too. Long-time residents here often recover with a spouse of similar age as the main helper. If packing or changing a draining dressing is too much for that person, Gateway can ask the treating clinician about bringing in home health.

In Ferguson you will see older frame and brick houses near the center of town, ranch homes in later subdivisions, and apartment complexes along the busier roads. Some households have three generations under one roof, and some older adults live alone. Skilled nursing, rehabilitation and assisted living facilities serve Ferguson and the neighboring cities. Gateway arranges partner clinician visits in homes, apartments and facilities alike. We ask who helps the patient day to day, because the treating clinician’s instructions need to reach that person, whether a daughter, a home aide or a charge nurse.

At home between visits

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

Assisted living and memory care raise different questions. Staff in these communities often cannot perform complex dressing changes, so the plan has to say who will: a home health nurse, a visiting clinician or, in some cases, family. A resident with dementia may not mention pain, may pull at a dressing, or may not remember instructions about the incision. The treating clinician takes this into account when choosing how the wound is a covered benefit and secured, and caregivers are asked to report behavior changes as well as wound changes. Gateway coordinates among the community’s staff, the home health agency and the family.

What to report and when to call 911

Between visits, the dressing and the skin around it tell you a lot. Contact the treating clinician or the surgeon’s office if you notice:

  • Redness or darkening of the skin that extends past where it was yesterday
  • Drainage that soaks through sooner than it used to
  • Fluid that turns thick, cloudy or foul smelling
  • Skin edges that pull farther apart
  • A firm, tender or soft, swollen lump beside the incision

Call 911 for heavy bleeding that does not stop with firm pressure, if tissue from inside the body bulges through an open abdominal wound, or if the person becomes confused, faint or very short of breath.

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 Ferguson →

How to get started in Ferguson

For a resident of a nursing home, assisted living or memory care community in Ferguson, a request for wound follow-up after a surgical site infection can come from the family, the resident or the facility’s nurses. Call 314-325-0126 and give us the facility name, the unit or room and the best nurse contact. Gateway speaks with the facility about its process for outside clinicians, confirms availability and coordinates a visit time that fits the resident’s day. After the visit, the treating clinician’s orders are given to facility nursing, and the family contact on file gets an update if the resident has agreed to that.

If you are arranging care for a relative in Ferguson, gather a few things first: the address in 63135, the phone number of whoever is home during the day, insurance cards, and the discharge folder if there was a hospital stay. Tell us if the patient uses a wheelchair or cannot answer the door. Ferguson is close to both interstates, so visits here fit well with others in Florissant, Hazelwood, Bridgeton, North St. Louis and the rest of North County. We confirm availability by location and care setting.

  • County: St. Louis County, Missouri
  • ZIP codes: 63135
  • Nearby hospitals: Christian Hospital in North County; SSM Health DePaul Hospital in Bridgeton (not affiliated with Gateway)
  • Nearby communities: Florissant, Hazelwood, North County, North St. Louis, Bridgeton
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Related care in Ferguson

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

Common questions

Can a clinician come to a home in Ferguson 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 Ferguson 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.

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.

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.

Are visits arranged throughout the 63135 ZIP code in Ferguson, including apartments?

Requests are welcome from anywhere in 63135, whether the patient lives in a house, a duplex, an apartment complex or a care facility. For apartments, give us the complex name, building and unit number, and tell us how to reach the door. Gateway confirms visit availability for the specific address and setting. If we cannot arrange a visit there, we will say so directly.

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.