What to know about surgical site infections

A surgical site infection is an infection that develops where a surgeon cut, in the days and weeks after an operation. Clinicians sort these infections by depth. Some stay in the skin and the fat just under the incision. Others reach the muscle layer and its covering. A third kind sits in the organ or space that was operated on, such as a joint or the abdomen. Depth matters because it shapes the treatment: a shallow infection may be handled by opening part of the incision and giving antibiotics, while a deep one can mean another procedure. Whatever the depth, the surgical team makes the diagnosis and directs treatment. Wound follow-up is what comes next, the regular checking and dressing of the incision while it recovers.

How the care plan is built

A care plan for an infected surgical wound answers a few practical questions. How will drainage be handled so the surrounding skin stays dry? Does a deep area need to be filled lightly so it does not seal over at the top? How often should the dressing be changed, and by whom? The treating clinician chooses dressings to match the wound as it is today and expects to change them as it becomes shallower and drier. If the surgeon has ordered negative pressure wound therapy, the plan covers the device as well. Everything is written as orders that home health nurses, facility nurses or family can follow.

Wound follow-up after a surgical site infection in Glen Carbon

People in Glen Carbon 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.

Single-family homes make up most of Glen Carbon, from small older houses in the original village to large newer homes on the bluff, along with attached villas, condominiums and apartments. Senior living, assisted living and rehabilitation care are close by, in the village and in neighboring Edwardsville and Maryville. Gateway arranges visits with partner clinicians wherever the patient is living. We ask a few questions about the setting, such as who will be home or which staff member to contact, and then confirm a visit that fits the household or the facility schedule.

Care at home

Supplies are a common sticking point after a surgical site infection, because the dressings ordered for an open, draining wound are rarely what was sent home from the hospital. Gateway coordinates the clinician’s supply orders so the right materials come to the house, and follows up on refills as the wound’s needs change. It helps to pick one clean, dry spot for everything, away from pets and the bathroom floor, with a small trash bag for used dressings. If a negative pressure pump has been ordered, we coordinate the equipment and the canisters and dressings that go with it.

In a facility

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.

Signs to tell the clinician about

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.

Primary care and overall health

Rebuilding tissue in an open surgical wound takes protein, calories and fluid, at a time when appetite is often poor. Nausea from antibiotics, pain medicine and simply feeling unwell after an operation can cut intake for weeks. A primary care clinician can look at weight, eating and lab results where needed, and suggest practical steps or a dietitian referral. Tobacco is the other large factor. Nicotine narrows small blood vessels and reduces the oxygen reaching the incision, so support for cutting down or quitting is part of wound recovery. Arranging primary care with wound care keeps these conversations from being put off.

Primary care at home in Glen Carbon →

Arranging wound follow-up after a surgical site infection in Glen Carbon

For a resident of a nursing home, assisted living or memory care community in Glen Carbon, 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.

Have these ready when you call about care in Glen Carbon: the address and ZIP code (62034), a daytime phone number, the reason for the request in a sentence or two, any recent hospital or rehabilitation stay, and the insurance card. Gateway also arranges care in Edwardsville, Collinsville, Granite City and other parts of Madison County. Glen Carbon is close to Interstate 270 and Route 159, but visits are still scheduled by location and care setting, and availability is confirmed case by case.

  • County: Madison County, Illinois
  • ZIP codes: 62034
  • Nearby hospitals: Anderson Hospital in Maryville (not affiliated with Gateway)
  • Nearby communities: Edwardsville, Collinsville, Madison County, Illinois, Granite City
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Other conditions and nearby communities

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

Common questions

Can a clinician come to a home in Glen Carbon 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 Glen Carbon 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.

What happens when the infection is near a joint replacement, mesh or other hardware?

Infection around implanted material is more serious, because bacteria can cling to surfaces that the body’s defenses and antibiotics reach poorly. The surgical team decides how to manage it, which may involve longer antibiotic treatment, a procedure to wash out the area, or removing or replacing the implant. Wound follow-up in this situation centers on close observation and prompt reporting, so the surgeon hears early about any drainage, opening or new pain.

How do wound care supplies get to a home in Glen Carbon?

Supplies are based on the treating clinician’s orders. After the visit, Gateway coordinates the supply order and follows up on delivery to the address you give us. Coverage for supplies depends on the plan and the care needed, so we cannot say in advance what a plan will pay. If something has not arrived or is running low, call 314-325-0126 so we can check on it.

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.