Wound follow-up after a surgical site infection in Kirkwood.

About surgical site infections

Every incision breaks the skin, the body’s main barrier against bacteria. Surgical teams lower the risk with skin cleansing, sterile technique and, for many operations, an antibiotic given shortly before the first cut. Even so, some bacteria reach the wound, most often from the patient’s own skin or, in bowel surgery, from the gut. Whether they take hold depends on how many there are and how well the tissue can defend itself. Tissue with poor blood flow, a collection of blood or fluid under the skin, or foreign material such as mesh gives bacteria a place to settle. Careful practice lowers the risk but cannot remove it, which is why the first weeks after any operation call for a close eye on the incision.

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.

Local context: Kirkwood

With skilled nursing facilities and senior living communities close by, people in Kirkwood often spend the first weeks after an operation in rehabilitation and then return to a house they have lived in for decades. A surgical site infection can show up on either side of that move. Gateway arranges wound follow-up in the facility and at home, and carries the dressing orders, measurements and antibiotic dates across the transfer. Neighbors and adult children who help out can ask the clinician what a worrying dressing looks like.

Housing in Kirkwood covers a wide range. There are century-old frame houses with deep front porches, brick bungalows, mid-century ranch homes, and condominiums and apartments close to downtown. The city also has senior apartments, assisted living, memory care and skilled nursing communities. Gateway arranges visits by partner clinicians in each of these settings. For a private home, we confirm the address, the entry steps and who will be there. For a facility resident, we coordinate with the nursing staff so the treating clinician’s orders and visit notes reach the people providing daily care.

Care at home

Home visits for an infected surgical wound are set at intervals the treating clinician chooses, and they often become less frequent as the wound settles. At each visit the clinician removes the dressing, examines and measures the wound, and redresses it. The dressing changes that fall between visits are done as ordered by a home health nurse, a caregiver who has been shown how, or you. Gateway schedules the visits, confirms the address and any access details, and sends the clinician’s update to the surgeon’s office, so your surgeon knows how the wound looks without waiting for your next appointment.

Care in skilled nursing and assisted living

A common point where things slip for an infected surgical wound is the move out of a facility. Orders that were followed on every shift have to be handed to a family, a home health agency or another facility, and details go missing. Before discharge, Gateway works with the facility’s nurses and discharge planner to gather the current dressing orders, the most recent wound measurements, the antibiotic plan and the date of the next surgeon visit. Where availability allows, wound visits continue at the new address, so the person checking the wound already knows what it looked like the week before.

Changes to report

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

Surgeons follow a patient for a set period after an operation. Primary care stays on. That longer view matters when a surgical site infection is only one of several things going on: leg swelling from heart or vein problems around a lower-limb incision, poor circulation, a chronic cough that strains an abdominal wound, or weakness that keeps someone in bed and at risk for pressure injuries. A primary care clinician manages those conditions and coordinates with the surgeon about activity. For people who cannot easily get to an office, Gateway can arrange primary care visits in the same setting as the wound visits.

Primary care at home in Kirkwood →

Arranging wound follow-up after a surgical site infection in Kirkwood

To arrange wound follow-up after a surgical site infection in Kirkwood, call Gateway at 314-325-0126. Patients, family members and caregivers can call directly, and a referral is not required. We will ask where the patient lives, what has been done for the wound so far and which clinicians are involved. Gateway then confirms whether a partner clinician is available for that address and care setting, requests the relevant records and schedules the visit. At that visit the treating clinician examines the wound and decides on the plan. Our job from then on is the coordination: orders, supplies, follow-up visits and keeping the care team informed.

Before you call 314-325-0126, it helps to have the patient’s name, the Kirkwood address or facility name, a phone number and the name of the regular doctor. If there was a recent hospital or rehab stay, tell us where it was and when it ended. Gateway also arranges care in nearby Webster Groves, Des Peres, Crestwood, Sunset Hills, Manchester and Valley Park, so relatives in two nearby towns can be discussed in one call. Visit days are confirmed for each address once a partner clinician is identified.

• County: St. Louis County, Missouri
• ZIP codes: 63122
• Nearby hospitals: St. Luke's Des Peres Hospital; Missouri Baptist Medical Center in Town and Country; Mercy Hospital South; SSM Health St. Clare Hospital in Fenton (not affiliated with Gateway)
• Nearby communities: Webster Groves, Des Peres, Crestwood, Sunset Hills, Manchester, Valley Park
• Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Related care in Kirkwood

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

• Diabetic foot ulcers
• Venous leg ulcers
• Pressure injuries and bed sores
• Arterial and mixed wounds
• Non-healing wounds
• Post-surgical wounds
• Reopened (dehisced) surgical wounds
• Skin tears and traumatic wounds
• Wounds with lymphedema
• Skin graft aftercare
• Wound VAC (NPWT) follow-up
• Wound follow-up after a surgical site infection in Webster Groves

Common questions