Understanding 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.

How the care plan is built

The wound is only part of the assessment. The treating clinician also asks about pain, appetite, bowel changes since the antibiotic began, and how well you are moving around. Temperature and pulse are noted. If the incision is on the abdomen, the clinician considers strain from coughing or lifting. If it is on a leg, swelling and circulation get attention. The clinician then decides who should hear about what, such as the surgeon for a suspected deep pocket or the primary care clinician for poor eating and drinking. The plan names what will be checked at each visit and what result would prompt a call.

Wound follow-up after a surgical site infection in Monroe and Clinton counties

Crossing a bridge for every wound check is a lot to ask of someone in Monroe and Clinton counties with an open, draining incision. When the surgeon is in Missouri, home or facility visits on the Illinois side can reduce those trips, with the treating clinician’s findings sent to the surgeon between rechecks. Home health agencies and supply vendors also differ by state and by plan. Gateway confirms the treating provider and your coverage first, whether that is Illinois Medicaid or a Missouri-based plan, so dressing orders and any pump or equipment go through channels your plan recognizes.

Homes in Monroe and Clinton counties include farmhouses, houses on small-town streets, newer subdivisions around Columbia and Waterloo, and apartments for older adults. Assisted living and skilled nursing care are available in several of the towns and serve the countryside around them. Gateway arranges visits with partner clinicians in both. For a farmhouse or a home outside town, we ask who will be there to let the clinician in and what time of day suits the household. For facilities, we speak with the nursing staff about visit timing, the resident’s chart and the treating clinician’s orders.

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.

Care in skilled nursing and assisted living

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.

Changes to report

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

Blood sugar and infection push each other in the wrong direction. Infection and the stress of surgery tend to raise glucose, and high glucose makes it harder for white blood cells to do their work and for new tissue to form. People with diabetes often see their readings change during a surgical site infection, and some people learn they have diabetes only when an incision is slow to recover. A primary care clinician can review the readings and decide whether the diabetes plan needs attention during this period. Gateway can arrange primary care alongside wound visits, so the two clinicians share what they find.

Primary care at home in Monroe and Clinton counties →

Arranging wound follow-up after a surgical site infection in Monroe and Clinton counties

For a resident of a nursing home, assisted living or memory care community in Monroe and Clinton counties, 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.

For a request from Monroe and Clinton counties, start with the town, the street or rural route address and directions from the nearest highway. Add a phone number, the patient’s doctor and any recent hospital stay. Gateway also arranges care in Belleville, the rest of St. Clair County and the wider Metro East, and in Oakville on the Missouri side. Longer distances mean visit times here are planned with travel in mind, and availability is confirmed for each location and care setting.

  • County: Monroe and Clinton counties, Illinois
  • ZIP codes: 62236, 62298, 62230, 62231
  • Nearby hospitals: HSHS St. Joseph's Hospital in Breese; Memorial Hospital Belleville; Mercy Hospital South (not affiliated with Gateway)
  • Nearby communities: Belleville, Illinois, St. Clair County, Illinois, Metro East, Oakville
  • 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 Monroe and Clinton counties page.

Common questions

Can a clinician come to a home in Monroe and Clinton counties 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 Monroe and Clinton counties 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 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.

Do I need a referral from my surgeon to start wound follow-up in Monroe and Clinton counties?

No. Patients, family members and caregivers can call Gateway directly, and surgical practices, hospitals and facilities can also refer. Once you call, we ask for the surgeon’s name and the hospital so the treating clinician can get the operative notes and current orders. Some health plans have their own referral or authorization rules, and those are checked along with your coverage before visits begin.

How far ahead should a family in Monroe and Clinton counties call before a planned discharge?

Call as soon as a discharge date or destination is being discussed, even if it is not final. Early notice gives Gateway time to request records, check availability for the address and coordinate with the hospital’s discharge planner. We cannot promise a specific visit date, and in rural areas scheduling has to account for travel. If the plan changes, call again so the request can be updated.

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.