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.

What an assessment covers

Early on, the treating clinician and the surgical team agree on where the wound is headed. Some infected incisions are left to close on their own from the base. Others are kept clean until the surgeon can stitch them shut. A few need more surgery before either can happen. The goal shapes the plan: which dressings are used, how often the wound is measured and what the surgeon wants reported. The clinician also sets markers of progress, such as less drainage, a shallower base and healthy red tissue. When a wound misses those markers over several visits, the plan is reviewed with the surgeon instead of simply continued.

Local context: Hazelwood

Many homes in Hazelwood 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.

Residential Hazelwood is a mix of ranch homes, split-levels, townhouses and a good number of apartment complexes near Lindbergh Boulevard and the interstate. Senior apartments, assisted living and skilled nursing facilities are located in the city and in the towns next to it. Gateway arranges partner clinician visits in all of them. Apartment visits need a building and unit number and sometimes a gate code. Facility visits are coordinated with the nurse in charge. In every setting the treating clinician decides the care, and Gateway handles the logistics.

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

Many people who develop a surgical site infection are already in a skilled nursing or rehabilitation center, recovering from a joint replacement, a hip repair or abdominal surgery. There, facility nurses change the dressing and take vital signs, and the attending physician oversees medical care. The treating wound clinician adds a focused wound exam at each visit, writes or recommends orders according to the facility’s process, and talks with the nurses who see the incision every day. Gateway arranges those visits with the facility and routes the clinician’s notes to the surgeon, so the three teams are reading the same record.

What to report and when to call 911

An infection that was settling can flare again, and the first clues are not always at the incision. Tell the treating clinician or the surgical team promptly about:

  • A temperature above the level your surgeon told you to report
  • Shaking chills or drenching sweats
  • Pain that climbs after days of easing
  • Nausea, poor appetite or unusual tiredness that is new
  • Blood sugar readings running higher than usual, if you check them

Call 911 if the person becomes confused, is hard to wake, breathes fast or with effort, has a racing heartbeat, or faints. Those signs can mean the infection is spreading through the body.

Primary care and overall health

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 Hazelwood →

How to get started in Hazelwood

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

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 surgical site infections, or see everything Gateway arranges on the mobile wound care in Hazelwood page.

Common questions

Can a clinician come to a home in Hazelwood 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 Hazelwood 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.

Who changes the dressing on the days between visits?

The treating clinician’s orders say how often the dressing is changed and who may do it. Depending on the wound and the setting, that may be a home health nurse, facility nursing staff, a family caregiver who has been taught, or the patient. If the wound is deep, in a spot you cannot see or reach, or simply more than you are comfortable with, say so. The clinician can adjust the plan.

Does Gateway arrange surgical site infection follow-up in nursing and rehabilitation facilities in Hazelwood?

Gateway arranges wound visits in skilled nursing facilities, rehabilitation centers, assisted living and memory care, as well as private homes. In a facility, the treating clinician works with the nursing staff and the attending physician under the facility’s own procedures. Facility staff or family can contact us to ask whether a partner clinician is available at a particular building in Hazelwood.

Does a doctor have to order the visit before Gateway will arrange care in Hazelwood?

No referral is needed to contact us. Patients, family members and caregivers in Hazelwood can call directly, and so can hospitals, facilities and physician offices. After the request, Gateway gathers records and connects the patient with a treating clinician, who determines what care is appropriate and writes any orders. A particular insurance plan may have its own referral rules, which the treating practice can check.

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.