Understanding 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

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.

Arranging this care in North St. Louis

People in North St. Louis often had their operation at one of the large medical centers nearby, and the surgeon’s office may be only a short distance away. Close is not the same as easy when you cannot drive, the parking garage means a long walk, and an open incision is draining. Gateway arranges wound checks where you live and sends the treating clinician’s findings to the surgical team, so the surgeon has current information between in-person rechecks. We also request records from the hospital where the surgery was done.

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.

Care at home

Recovering from an operation at home already means lifting limits, less driving and a body that tires quickly. An infection adds surgeon rechecks, sometimes lab work, and a wound that has to stay dressed. Bringing wound visits to the house removes some of those trips. For appointments that still have to happen in person, such as a recheck with the surgeon, Gateway can help with transportation arrangements and send the latest wound notes to the office beforehand. If home health is already coming for therapy or nursing, we coordinate so the wound orders reach that agency and the two schedules do not collide.

Care in skilled nursing and assisted living

In a rehabilitation setting, an infected incision has to share the day with therapy. Dressing changes work best when they are timed so a leaking or painful wound does not cut a session short, and therapists need to know about any movement limits the surgeon has set. Some residents are also receiving intravenous antibiotics through a long-term line, which facility nurses manage under the prescriber’s orders. The treating clinician watches how the wound responds and tells the attending physician and surgeon what it shows. Gateway helps keep track of the dates that matter, including antibiotic end dates, surgeon rechecks and the planned discharge.

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

Rebuilding tissue in an open surgical wound takes protein, calories and fluid, at a time when appetite is often poor. Nausea from antibiotics, pain medicine and simply feeling unwell after an operation can cut intake for weeks. A primary care clinician can look at weight, eating and lab results where needed, and suggest practical steps or a dietitian referral. Tobacco is the other large factor. Nicotine narrows small blood vessels and reduces the oxygen reaching the incision, so support for cutting down or quitting is part of wound recovery. Arranging primary care with wound care keeps these conversations from being put off.

Primary care at home in North St. Louis →

Getting care arranged in North St. Louis

You may already have a surgeon, a wound clinic or a home health nurse and still want help with wound follow-up after a surgical site infection closer to home in North St. Louis. That is a fine reason to call 314-325-0126. Tell us who is treating the wound now and what is not working, whether that is the travel, the gaps between appointments or unclear instructions. Gateway does not replace your current clinicians. We can arrange for a partner clinician to see the wound where you live and, with your permission, share notes with the offices already involved so the plans agree.

Have these ready when you call 314-325-0126: the patient’s name, street address and ZIP code, a main phone number and a backup, and the name of any doctor or health center they use. If the patient stays with different relatives during the week, say so. Gateway also arranges care elsewhere in the City of St. Louis, including Downtown and the Central West End, and across the line in Ferguson and North County. Visit availability is confirmed for each address, and a reachable phone number keeps scheduling on track.

  • 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 surgical site infections, or see everything Gateway arranges on the mobile wound care in North St. Louis page.

Common questions

Do I need a referral from my surgeon to start wound follow-up in North St. Louis?

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.

Will my insurance pay for wound follow-up visits in North St. Louis after a surgical site infection?

That depends on your plan, the treating provider and the care that is needed. You can ask us about Medicare, Medicare Advantage, Medicaid and commercial plans, and we help confirm participation and benefits with the treating practice before care starts. Have your insurance card nearby when you call. Decisions about what is paid for rest with your plan, not with Gateway.

Is a surgical site infection contagious to the people I live with?

Ordinary contact such as sitting together or sharing a meal is generally not a concern. Bacteria can spread through direct contact with wound drainage or used dressings. The usual precautions are washing hands before and after touching the dressing, bagging used materials and not sharing towels. If the culture showed a resistant type of bacteria, or someone at home has a weak immune system, ask the treating clinician whether more steps are needed.

What if the patient’s phone number changes or they move within North St. Louis?

Call us with the new information as soon as you can. Visits are arranged by address, so a move, even a few blocks, needs to be updated before the next visit. If the patient’s phone is out of service, give us a relative’s or neighbor’s number as a backup. Keeping contact details current is the simplest way to avoid a missed visit.

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.