Care for a reopened surgical wound in Hazelwood.

About reopened surgical wounds

Once an incision has opened, the usual path is what clinicians call healing by secondary intention. Instead of the edges being joined, the gap fills from the base with new red, bumpy tissue, the wound draws inward, and skin grows across from the sides. That happens in stages over weeks, and for larger or deeper openings it can run into months. Early on, drainage may be heavy and dressing changes frequent. As the wound fills, drainage usually lessens and the opening measures smaller. Progress is rarely a straight line. A wound may stall, form a pocket under one edge, or need unhealthy tissue cleared before it moves again. The scar that results is often wider than the original line.

What an assessment covers

Measurements matter more than impressions with an open surgical wound, so the treating clinician records the same points at each visit and compares them over time:

• Length, width and depth of the opening
• The kind of tissue in the base, and how much of it looks healthy
• Any tunnel or pocket under the edges, and which direction it runs
• How much drainage the dressing held, and its color
• The condition of the surrounding skin

When the numbers shrink from visit to visit, the plan is working. When they hold still or grow, the clinician looks for a reason, such as infection, strain on the area or a dressing that no longer suits the wound, and adjusts the orders.

Arranging this care in Hazelwood

Many houses in Hazelwood were built with the bedrooms upstairs and the only full bathroom on the second floor. For someone whose abdominal or hip incision has opened, that layout decides a lot: where they sleep, how often they climb, and where a dressing change can happen in good light. The treating clinician can see the setup on a home visit and shape the plan around it. Long-time residents are often cared for by a spouse of similar age, so we ask who will be doing dressing changes and whether home health nursing should be part of the plan.

Hazelwood stretches along Interstate 270 in North County, an irregularly shaped city bordered by Florissant, Bridgeton and the land around Lambert airport. Warehouses and business parks share the map with residential streets, and Lindbergh Boulevard ties the two together. People here are used to getting on the highway for almost everything. That works until a health problem makes travel difficult. Wound care and primary care brought to a Hazelwood home or care facility let treatment go on without a highway trip each time, which matters most for patients who depend on someone else to drive.

At home between visits

Supplies for an open surgical wound add up quickly: packing or filler material, cover dressings, tape or wraps, wound cleanser and gloves. Once the treating clinician writes the orders, Gateway coordinates the supply request so the ordered items can be sent to the house, and updates it when the orders change. Running out over a weekend is a common and avoidable problem, so tell us when you are down to a few days of dressings. The house itself matters too. A bed that is hard to get out of, a low chair or a laundry basket that needs carrying can all strain a fresh abdominal or hip incision. Mention those obstacles during the visit.

In a facility

In a facility, wound orders live in the resident’s chart and go through the attending physician. A partner clinician who visits for a reopened incision documents the assessment, recommends or writes orders according to the facility’s process, and leaves clear instructions for the nurses who will do the dressing changes. Gateway handles the scheduling with the nursing leadership, requests surgical records the facility may not have received, and coordinates with the surgeon’s office about follow-up appointments. That last piece matters, because a trip out to the surgeon means transportation, an escort and a dressing that will hold up through the ride.

Signs to tell the clinician about

A reopened incision should look a little better, or at least no worse, each time the dressing comes off. Tell the treating clinician or the surgeon’s office promptly if you notice:

• The gap growing longer, wider or deeper
• Thick, cloudy or foul-smelling drainage
• Redness that is spreading outward from the edges
• A fever, chills or a new sense of being ill
• Stitches, staples or mesh showing that were not visible before

Call 911 if an abdominal incision bursts open, if anything bulges out through the wound, if bleeding will not stop, or if you have chest pain or trouble breathing.

Primary care and overall health

Closing an open surgical wound takes raw material. The body needs enough protein, calories and fluid to lay down new tissue, and appetite is often poor after an operation, especially in older adults. A primary care clinician can look at weight changes, check for problems such as trouble chewing or swallowing, nausea or low mood, and decide whether lab work or a nutrition referral is warranted. Wound drainage itself carries protein out of the body, which adds to the need. Ask before starting supplements, since the right choice depends on kidney function, diabetes and the medicines you take. Arranging wound care and primary care together lets both clinicians work from the same picture.

Primary care at home in Hazelwood →

Getting care arranged in Hazelwood

If you have been managing a wound mostly on your own and are looking for care for a reopened surgical wound in Hazelwood, 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.

Hazelwood addresses can be confusing because the city has an irregular outline and borders several other municipalities. When you call, give the full street address in 63042 and the name of the apartment complex or subdivision. Have a daytime phone number and the name of the patient’s doctor. Tell us if the clinician should call on arrival instead of knocking. Nearby, Gateway also arranges care in Florissant, Bridgeton, Ferguson, Maryland Heights and across North County, and Hazelwood visits can be planned with those.

• County: St. Louis County, Missouri
• ZIP codes: 63042
• Nearby hospitals: SSM Health DePaul Hospital in Bridgeton; Christian Hospital in North County (not affiliated with Gateway)
• Nearby communities: Florissant, Bridgeton, Ferguson, Maryland Heights, North County
• Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Other conditions and nearby communities

Read the full guide to reopened surgical wounds, or see everything Gateway arranges on the mobile wound care in Hazelwood page.

• Diabetic foot ulcers
• Venous leg ulcers
• Pressure injuries and bed sores
• Arterial and mixed wounds
• Non-healing wounds
• Post-surgical wounds
• Surgical site infections
• Skin tears and traumatic wounds
• Wounds with lymphedema
• Skin graft aftercare
• Wound VAC (NPWT) follow-up
• Care for a reopened surgical wound in Florissant
• Care for a reopened surgical wound in Ferguson
• Care for a reopened surgical wound in Maryland Heights
• Care for a reopened surgical wound in North County

Common questions