Understanding post-surgical wounds
A few common beliefs cause trouble after surgery. One is that a wound should be left open to the air to dry out, when most surgeons want an incision covered and protected for a period they specify. Another is that a closed skin surface means the job is done, although the layers underneath are still gaining strength and lifting limits still apply. People also assume that a little separation at one end will close by itself, or that more ointment and more cleaning are always better. And many wait for the next scheduled appointment to mention a change. The safer habits are simple: follow the written instructions, leave strips and scabs alone, and report changes early.
What the treating clinician looks at
The treating clinician starts with the paperwork: what operation was done and when, how the incision was closed, what the surgeon ordered for dressings, bathing and activity, and when the next surgical appointment is. Then comes the wound itself. The clinician looks at whether the edges meet along the full length, measures any open area, notes the color and amount of drainage, and checks the surrounding skin for warmth, firmness or swelling. Stitches, staples and drains are checked against the surgeon’s removal plan. From there the clinician writes or updates orders that fit within the surgeon’s instructions, and Gateway sends the findings to the surgical office.
Post-surgical wound care in North St. Louis
In North St. Louis, many people recover from surgery in apartments or older two- and three-story homes, and stairs are the first obstacle. Lifting limits after abdominal, chest or joint surgery can make a walk-up hard to leave, so follow-up that comes to the door spares the incision a trip. Before a visit, Gateway asks about buzzers, entry codes and parking so the treating clinician can reach you. Large hospitals are close, which helps when the surgeon wants to see a wound in person, and we can help arrange transportation when that trip is needed.
The housing here is mostly brick: two-story single-family homes, two-family and four-family flats, and senior apartment buildings, usually with steps up to the front door. Second-floor flats and steep stairs are a real obstacle for someone with a leg wound or poor balance. Skilled nursing facilities and assisted living are part of the picture too. Gateway arranges partner clinician visits in any of these settings. When you call, tell us about the steps, which door to use and whether someone will be home, so the visit can start without delays.
At home between visits
Many people go home after surgery with a home health agency already assigned. In that case the home health nurse usually handles routine dressing changes, and the treating clinician arranged through Gateway adds wound-focused assessments and orders. We make sure both are reading the same instructions, since two sets of dressing orders in one house is a common source of mistakes. If no agency is involved, the clinician decides who can safely change the dressing, which may be you, a family member or a nurse, and Gateway follows up on whatever that plan requires.
For residents of nursing and senior living communities
A resident with dementia may not remember having surgery, may pull at a dressing or pick at staples, and may not be able to say that an incision hurts. In memory care, the treating clinician relies on staff observations and plans for these realities, for example with a dressing that is harder to remove and clothing that covers the site. Staff are told which behaviors, such as new restlessness, guarding one side or refusing to walk, might signal a wound problem. Gateway keeps the family or legal representative updated and sends findings to the attending physician and the surgeon.
Signs to tell the clinician about
A healing incision should look a little better, or at least no worse, each day. Call the surgeon’s office or the treating clinician when the trend reverses:
- A faint pink edge has become a wide red patch
- A dry incision starts to leak
- Soreness becomes throbbing or sharp
- The area feels hot or tight
- One calf becomes painful, swollen or warm
Do not wait on these to see what happens. Call 911 if deep tissue shows through an opened incision, if blood soaks dressings faster than you can replace them, or if you have chest pain, sudden breathlessness, fainting or new confusion.
Primary care and overall health
People leave the hospital with a changed medication list: new pain medicine, perhaps a blood thinner, an antibiotic course, stool softeners, and old prescriptions that were paused or adjusted. Some of these affect bleeding, bruising and how an incision heals, and it is easy to end up taking a duplicate or missing something that was meant to restart. A primary care clinician can go through the full list after discharge and sort out questions with the surgeon and the pharmacy. Arranging that review alongside wound visits means the wound care clinician knows what the patient is actually taking.
Arranging post-surgical wound care in North St. Louis
People asking about post-surgical wound care in North St. Louis usually want to know what the first visit involves. Before it, Gateway collects the records the treating clinician asks for and confirms the time and place with you. During it, the clinician looks at the wound and the skin around it, measures it, asks about your health and medications and explains what they recommend. Afterward, the orders go to whoever does the daily care, supplies are requested and a follow-up is planned. Our guide to how mobile wound care visits work has more. To begin, call 314-325-0126. Whether a visit can be arranged is confirmed for your location.
For hospital care, people in North St. Louis commonly go to Barnes-Jewish Hospital, SSM Health Saint Louis University Hospital or Christian Hospital in North County. Gateway has no affiliation with any of them. A patient may be sent home with dressing instructions and a follow-up appointment that is hard to get to. Families can call us to ask whether wound care or primary care visits can be arranged at home. Discharge planners and social workers can refer by phone or fax, and should include the discharge summary, the orders and a working phone number for the patient or a relative.
- County: City of St. Louis, Missouri (an independent city)
- ZIP codes: 63106, 63107, 63113, 63115, 63120, 63147
- Nearby hospitals: Barnes-Jewish Hospital; SSM Health Saint Louis University Hospital; Christian Hospital in North County (not affiliated with Gateway)
- Nearby communities: St. Louis City, Downtown St. Louis, Central West End, Ferguson, North County
- Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation
Related care in North St. Louis
Read the full guide to post-surgical wounds, or see everything Gateway arranges on the mobile wound care in North St. Louis page.
- Diabetic foot ulcers
- Venous leg ulcers
- Pressure injuries and bed sores
- Arterial and mixed wounds
- Non-healing wounds
- Reopened (dehisced) surgical wounds
- Surgical site infections
- Skin tears and traumatic wounds
- Wounds with lymphedema
- Skin graft aftercare
- Wound VAC (NPWT) follow-up
- Post-surgical wound care in the City of St. Louis
- Post-surgical wound care in Downtown St. Louis
- Post-surgical wound care in the Central West End
- Post-surgical wound care in Ferguson
Common questions
Do I need a referral from my surgeon to arrange wound follow-up in North St. Louis?
No. Patients, family members and caregivers can call Gateway directly, and surgical offices and discharge planners can refer as well. Once you call, we ask for permission to request the operative report and discharge instructions, because the treating clinician needs the surgeon’s orders before making decisions about the incision. Some health plans have their own referral rules, which we help you check.
What should I have ready for the first wound visit after surgery?
Gather the discharge papers, the list of medications you are taking now, any dressing supplies the hospital sent home, and the date of your next surgeon appointment. If you track drain output or temperature, keep that log handy. It also helps to write down when the dressing was last changed and any changes you have noticed since leaving the hospital.
Will Medicare or my insurance pay for post-surgical wound care?
You can ask us about Medicare, Medicare Advantage, Medicaid and commercial plans. Whether a visit or a supply is paid for depends on the treating provider, your specific plan and the care the clinician finds is needed, so we cannot answer in general terms. When you call, we take your plan information and help you find out what applies before a visit is scheduled.
My grandmother lives in a senior apartment building in North St. Louis. Can a clinician see her there?
Yes, visits can be arranged in senior apartment buildings. Give us the building’s street address, her apartment number and how visitors get in, such as a front desk or buzzer. Let her know someone will be calling so she expects it. Gateway confirms availability for her location, and you or she will be contacted about the visit day before anyone comes.
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.