What to know about reopened surgical wounds

Dehiscence is the term clinicians use when a surgical incision separates after it has been closed. The closure might have been stitches, staples, adhesive strips or skin glue. In a partial dehiscence, only the skin and the fatty layer just beneath it come apart, and the gap may be no longer than a fingertip. In a deeper one, the strong layer that holds the muscles together also gives way, which is a more serious problem and belongs with the surgeon right away. Most reopened incisions show up while the person is still in the early weeks of recovery, often around the time staples or stitches come out. Some open all at once. Others begin as a small damp spot along the line that slowly widens.

What the treating clinician looks at

A first visit for a reopened incision starts before the dressing comes off. The treating clinician wants to know which operation was done and when, how the incision was closed, whether mesh, hardware or a drain was placed, and what the surgeon has said since the opening appeared. Then comes the wound itself: its length along the incision line, its depth, and whether the base is firm or gives way to a deeper space. The clinician gently checks under the edges for pockets, notes any stitches or staples still in place, and looks at the skin on both sides of the line. Those findings, set against the surgeon’s instructions, shape the first set of orders.

Arranging this care in St. Clair County

Some people in St. Clair County have surgery at an Illinois hospital and recover with Illinois home health. Others cross the river for an operation in St. Louis and then come home. Either way, a dehisced wound needs a treating clinician who can see patients on the Illinois side and who works with your plan. Illinois Medicaid and Missouri Medicaid are separate programs, and Medicare Advantage and commercial plans can differ by state. Before a visit is scheduled, Gateway confirms the treating provider and encourages you to check your benefits with the plan.

St. Clair County begins at the Mississippi riverfront in East St. Louis and Cahokia Heights, climbs the bluffs to Belleville, the county seat, and continues through Swansea, Fairview Heights, O’Fallon and Shiloh out to Mascoutah, Lebanon and Freeburg. Interstate 64 and Illinois Route 15 carry much of the traffic. The county holds some of the oldest neighborhoods in the Metro East and some of the newest, and in all of them there are people who cannot get to a clinic easily. Arranging wound care and primary care where they live is the practical answer.

When care happens at home

Many people come home from surgery with a home health agency already in place. When an incision opens, Gateway coordinates the wound care visits with that agency so the nurse and the treating clinician are following one set of orders, not two. If the clinician orders a wound therapy device, the agency nurse typically handles its scheduled dressing changes, and we help with the paperwork and delivery arrangements for the pump and its supplies. If no agency is involved and the wound needs skilled dressing changes several times a week, the treating clinician can decide whether a home health referral makes sense.

In a facility

With memory care residents, the hardest part of a reopened incision is often keeping the dressing on. A resident who does not remember the surgery may pick at the tape, pull out packing or tug on device tubing, and may not be able to say that the area hurts. The treating clinician takes that into account when choosing dressings and how they are secured. Staff watch for nonverbal signs such as guarding the area, restlessness or resisting being moved. Gateway coordinates visits for the time of day when the resident is usually calmest, and keeps the family and the attending physician informed of what the clinician finds.

Signs to tell the clinician about

Some changes come on gradually and some arrive in a moment. A pop or tearing feeling at the incision, followed by a gush of pink fluid, can mean deeper layers are separating, and the surgeon should hear about it right away. Also report:

  • A bulge under or beside the incision when you cough or stand
  • Drainage that soaks through a fresh dressing quickly
  • Red streaks, or warmth that has moved beyond the dressing border
  • Shaking chills or a raised temperature

Call 911 if the wound opens wide, if you can see tissue or organs coming through it, or if you are short of breath, faint or bleeding heavily.

Primary care and overall health

New tissue is built from what the bloodstream delivers, so the conditions a primary care clinician manages have a direct line to a reopened incision. High blood sugar slows the cells that rebuild tissue and fight bacteria. Narrowed arteries deliver less oxygen to an incision on the leg or foot. Swelling from heart, kidney or vein problems stretches the skin around a wound and keeps it wet. None of these can be fixed with a dressing. When Gateway arranges wound care, we can also help arrange primary care with a partner clinician, so that the person measuring the wound and the person managing those conditions are sharing information.

Primary care at home in St. Clair County →

Getting care arranged in St. Clair County

People asking about care for a reopened surgical wound in St. Clair County 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.

St. Clair County requests start with the town and ZIP code, since Belleville alone has several. Keep the patient’s phone number, medication list, insurance card and doctors’ names nearby when you call. Gateway arranges care in Belleville, O’Fallon, Fairview Heights and neighboring Collinsville, and across the wider Metro East. The county runs from city blocks near the river to open farmland in the east, and availability is confirmed for each location and care setting before a visit is scheduled.

  • County: St. Clair County, Illinois
  • ZIP codes: 62220, 62221, 62223, 62226, 62269, 62208, 62258, 62254
  • Nearby hospitals: Memorial Hospital Belleville; Memorial Hospital Shiloh; HSHS St. Elizabeth's Hospital in O'Fallon, Illinois; Touchette Regional Hospital in Cahokia Heights (not affiliated with Gateway)
  • Nearby communities: Belleville, Illinois, O'Fallon, Illinois, Fairview Heights, Collinsville, Metro East
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Related care in St. Clair County

Read the full guide to reopened surgical wounds, or see everything Gateway arranges on the mobile wound care in St. Clair County page.

Common questions

Can someone come to a home in St. Clair County to check a surgical incision that has opened?

In many cases, yes. Gateway arranges home visits with partner clinicians for people in St. Clair County whose incision has separated, and the clinician examines the wound in the room where you are recovering. Availability is confirmed by location and care setting, so the first step is a call to 314-325-0126. If the incision has just opened and your surgeon does not know yet, call the surgical office as well.

What should I have ready when I call about a reopened incision?

A few details help us request the right records: the name of the surgeon and hospital, the type and date of the operation, when the opening was first noticed, and whether a home health agency is already visiting. Have your insurance cards and a list of medicines nearby. Share these by phone at 314-325-0126. The web form is only for your name and number, so leave medical details out of it.

Will Medicare or my health plan pay for care for a reopened incision in St. Clair County?

You can ask us about Medicare, Medicare Advantage, Medicaid and commercial plans. Whether a visit, a dressing supply or a wound therapy device is a covered benefit depends on the treating provider, your plan and the care the clinician orders, so we cannot tell you in advance that something will be paid for. For patients in St. Clair County, Gateway confirms the treating provider first and suggests you verify benefits with your plan before care starts.

My father lives in a memory care community in St. Clair County. Can wound care come to him there?

Yes, Gateway arranges visits in memory care. Being seen in a familiar room with familiar staff nearby can make an assessment easier for a person with dementia. We coordinate with the staff on a good time of day for your father, and the treating clinician leaves orders the staff can follow. As his family, you can ask to be updated after visits.

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.