What to know about surgical site infections

The course of a surgical site infection usually has two parts. The first is short and intense: the incision becomes painful, red and swollen, often some days after you thought the hard part was over, and the surgical team steps in. The second part is slower. Once the infection is controlled, an incision that was opened has to fill with new tissue from its base upward, and that work goes on well after the last antibiotic dose. Drainage normally lessens, the wound gets shallower and the edges draw inward. Progress is not always even. A wound can stall, or a pocket can form under skin that looks closed. Some wounds are stitched shut later by the surgeon once they are clean.

What the treating clinician looks at

The first visit starts with the story of the operation. The treating clinician wants to know what procedure was done and when, whether mesh, hardware or a joint implant was placed, and what the surgical team has done about the infection so far. That includes whether the incision was opened, whether a culture was taken, which antibiotic was prescribed and when it is due to end. Gateway requests the operative and discharge records so the clinician is not relying on memory alone. With that background, the clinician examines the wound and sets a dressing plan that fits the surgeon’s instructions.

Local context: O’Fallon, Illinois

Crossing a bridge for every wound check is a lot to ask of someone in O’Fallon 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.

Newer single-family homes make up much of O’Fallon, joined by older houses near downtown, townhomes, apartments and communities built for older adults. Assisted living, memory care and skilled nursing are available in and near the city. Gateway arranges visits with partner clinicians in all of these settings. When relatives are helping from a distance, we can plan the visit with them by phone and keep them posted. When the patient lives in a facility, we coordinate with the staff so the treating clinician can review the chart and leave clear orders.

At home between visits

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.

For residents of nursing and senior living communities

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.

Changes to report

Between visits, the dressing and the skin around it tell you a lot. Contact the treating clinician or the surgeon’s office if you notice:

  • Redness or darkening of the skin that extends past where it was yesterday
  • Drainage that soaks through sooner than it used to
  • Fluid that turns thick, cloudy or foul smelling
  • Skin edges that pull farther apart
  • A firm, tender or soft, swollen lump beside the incision

Call 911 for heavy bleeding that does not stop with firm pressure, if tissue from inside the body bulges through an open abdominal wound, or if the person becomes confused, faint or very short of breath.

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 O'Fallon →

Arranging wound follow-up after a surgical site infection in O’Fallon

People asking about wound follow-up after a surgical site infection in O’Fallon 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.

Say “O’Fallon, Illinois” and give the ZIP code 62269 when you call, since there is an O’Fallon in Missouri too. Have the street address, a phone number, the discharge date if there was a hospital stay, and the names of the patient’s doctors. Gateway also arranges care in Fairview Heights, Belleville, Collinsville and other parts of St. Clair County. O’Fallon is easy to reach from Interstate 64, but availability still depends on location and care setting, and we confirm it before scheduling.

More wound care in O’Fallon

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

Common questions

Can a clinician come to a home in O’Fallon 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 O’Fallon 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.

Can I shower with an open surgical wound?

Follow the surgical team’s instructions, because the answer differs by operation, by wound and by dressing. Some people are cleared to shower with the wound covered or uncovered. Others are asked to keep the area dry. Soaking in a bath, hot tub or pool is generally off limits until the surgeon says otherwise. If you were not told, ask before your next dressing change, and ask what to do if the dressing gets wet.

Should I keep my surgeon appointments if a wound clinician is already visiting?

Yes. Wound visits add to the surgeon’s care and do not replace it. The surgeon decides about antibiotics, further procedures, closing the wound and when you can return to normal activity. The treating clinician’s notes can make those appointments more productive, because the surgeon sees how the wound has changed since the last check. If getting to the office is the obstacle, tell us when you call.

My mother is moving from our house in O’Fallon to assisted living nearby. Does her care have to start over?

It should not have to. Let us know the move date and the name of the community. Gateway confirms availability for the new setting, introduces the request to the facility staff and coordinates the transfer of records and current orders. The treating clinician decides whether anything in the plan needs to change after the move. We also update where supplies are sent.

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.