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

A care plan for an infected surgical wound answers a few practical questions. How will drainage be handled so the surrounding skin stays dry? Does a deep area need to be filled lightly so it does not seal over at the top? How often should the dressing be changed, and by whom? The treating clinician chooses dressings to match the wound as it is today and expects to change them as it becomes shallower and drier. If the surgeon has ordered negative pressure wound therapy, the plan covers the device as well. Everything is written as orders that home health nurses, facility nurses or family can follow.

Local context: Oakville

Many homes in Oakville 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.

Oakville is mostly single-family subdivisions: ranch homes, two-story houses, and newer villas and condominiums that attract people who are downsizing. Walkout basements are common, and some older adults live in a lower-level suite in a son’s or daughter’s house. Assisted living, memory care and skilled nursing communities are found in Oakville and just north in Mehlville. Gateway arranges partner clinician visits in each setting and asks practical questions first, such as which level the patient lives on and who will answer the door.

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

Assisted living and memory care raise different questions. Staff in these communities often cannot perform complex dressing changes, so the plan has to say who will: a home health nurse, a visiting clinician or, in some cases, family. A resident with dementia may not mention pain, may pull at a dressing, or may not remember instructions about the incision. The treating clinician takes this into account when choosing how the wound is a covered benefit and secured, and caregivers are asked to report behavior changes as well as wound changes. Gateway coordinates among the community’s staff, the home health agency and the family.

What to report and when to call 911

Some changes worth reporting come from the treatment, not the wound. Let the prescriber and the treating clinician know about:

  • Watery diarrhea, especially several times a day
  • A new rash, itching or hives
  • Vomiting that keeps you from taking the antibiotic
  • White patches in the mouth or other new irritation
  • Redness, warmth or drainage that returns after the antibiotic course ends

Report these promptly so the prescriber can decide what to do. Do not stop or restart a medicine on your own. Call 911 for swelling of the lips, tongue or throat, trouble breathing, or widespread hives with dizziness, which can signal a severe allergic reaction.

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 Oakville →

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

Before anything is scheduled, Gateway checks two things for every request for wound follow-up after a surgical site infection in Oakville: whether a partner clinician serves that address and care setting, and what the patient’s plan requires from the treating provider. Neither is assumed. If both line up, we arrange the visit and gather records. If something stands in the way, we say so, and our guide to following up on a request explains what to ask next. Gateway coordinates the care and does not make clinical decisions. Those belong to the treating clinician who sees the wound. Start by calling 314-325-0126, or ask a family member to call for you.

Call 314-325-0126 with the patient’s Oakville address, phone number, date of birth and doctor’s name, and tell us about any recent hospital or rehabilitation stay. Mailing addresses here say St. Louis, so mention Oakville or the 63129 ZIP code. Gateway also arranges care in Mehlville, the rest of South County, and across the Meramec River in Arnold and Imperial. Oakville is tucked between two rivers, with only a few roads in and out, so visit days are confirmed by location.

  • County: St. Louis County, Missouri
  • ZIP codes: 63129
  • Nearby hospitals: Mercy Hospital South (not affiliated with Gateway)
  • Nearby communities: Mehlville, Arnold, South County, Imperial
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

More wound care in Oakville

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

Common questions

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

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 Oakville.

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.

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.

Can I use the website form to describe my wife’s wound and give our Oakville address?

Please use the form for contact details only: your name and phone number. Do not enter medical details there. Someone from Gateway will call you back, and you can describe your wife’s situation and give the Oakville address by phone. If you would rather talk now, call 314-325-0126. For anything that looks like an emergency, call 911 instead.

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.