Understanding surgical site infections
Several common beliefs about infected incisions cause trouble. One is that an infection means the surgery failed or that someone was careless, when it is a recognized risk of any operation. Another is that the problem ends with the antibiotic prescription. The medicine fights bacteria, but it does not close a wound that had to be opened. People are also alarmed when the surgeon leaves the incision open, though that is usually deliberate. And many assume a wound that looks better on the surface is finished, when a deeper pocket may still be draining. The most useful habit is to describe exactly what you see to the clinician, without deciding first whether it is good or bad.
What the treating clinician looks at
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.
Wound follow-up after a surgical site infection in St. Charles
Newer subdivisions and growing senior living communities in St. Charles sit farther from the specialists who handle surgical complications. When an infected incision needs dressings that a nearby pharmacy does not stock, or a negative pressure pump with its canisters, waiting on an order can leave a gap. Gateway coordinates the clinician’s supply orders early and confirms a delivery address that works for a household where everyone is out during the day. For residents of senior living, we coordinate visit times with community staff so someone who knows the resident is present.
Near the river, St. Charles has older frame and brick houses, some with steep porch steps and narrow staircases. Farther out are ranch homes, split-levels, apartment complexes and newer villas. The city has a wide choice of senior apartments, assisted living, memory care, and skilled nursing and rehabilitation centers. Gateway arranges partner clinician visits wherever the patient lives. In a private home we plan around the family’s routine. In a facility we coordinate with the charge nurse or wound nurse, and the treating clinician’s orders are shared with staff after each visit.
Care at home
Most of the work with an infected incision happens on the days nobody visits. Someone has to change the dressing as ordered, notice what the old one looks like and keep track of how you feel. Many families keep a simple notebook by the supplies: the date, how much drainage was on the dressing, the temperature if the clinician asked for it, and any questions. That record makes each visit more useful. If changing a deep dressing is more than a spouse or adult child can manage, tell us. Gateway can ask the treating clinician about a home health referral so a nurse shares the load.
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.
How primary care fits in
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.
Getting care arranged in St. Charles
To arrange wound follow-up after a surgical site infection in St. Charles, call Gateway at 314-325-0126. Patients, family members and caregivers can call directly, and a referral is not required. We will ask where the patient lives, what has been done for the wound so far and which clinicians are involved. Gateway then confirms whether a partner clinician is available for that address and care setting, requests the relevant records and schedules the visit. At that visit the treating clinician examines the wound and decides on the plan. Our job from then on is the coordination: orders, supplies, follow-up visits and keeping the care team informed.
A little preparation helps. Write down the patient’s full address in St. Charles with the ZIP code (63301, 63303 or 63304), a phone number, the regular doctor and pharmacy, and any recent hospital or rehab stay. Gateway also arranges care in St. Peters, Cottleville, Weldon Spring and the rest of St. Charles County, and across the river in Bridgeton. Some addresses with a St. Charles ZIP code are outside the city limits, so a few words about how to find the house are useful when visit days are confirmed.
- County: St. Charles County, Missouri
- ZIP codes: 63301, 63303, 63304
- Nearby hospitals: SSM Health St. Joseph Hospital in St. Charles; Barnes-Jewish St. Peters Hospital (not affiliated with Gateway)
- Nearby communities: St. Peters, St. Charles County, Bridgeton, Cottleville, Weldon Spring
- Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation
More wound care in St. Charles
Read the full guide to surgical site infections, or see everything Gateway arranges on the mobile wound care in St. Charles page.
- Diabetic foot ulcers
- Venous leg ulcers
- Pressure injuries and bed sores
- Arterial and mixed wounds
- Non-healing wounds
- Post-surgical wounds
- Reopened (dehisced) surgical wounds
- Skin tears and traumatic wounds
- Wounds with lymphedema
- Skin graft aftercare
- Wound VAC (NPWT) follow-up
- Wound follow-up after a surgical site infection in St. Peters
- Wound follow-up after a surgical site infection in St. Charles County
Common questions
Do I need a referral from my surgeon to start wound follow-up in St. Charles?
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.
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.
What does a wound culture tell the care team?
A culture is a sample from the wound sent to a laboratory to identify which bacteria are growing and which antibiotics work against them. Results usually take a few days. The prescriber may keep the first antibiotic or switch based on the report. A culture is read together with how the wound looks, because bacteria can be found on wounds that are not infected.
How do I refer a resident of a St. Charles nursing facility for wound care?
Call 314-325-0126 or fax the referral to 314-786-7966. Include the resident’s name, the facility name and unit, the reason for referral, recent wound notes and a staff contact. Gateway arranges a partner clinician’s visit at the St. Charles facility and coordinates orders and documentation with your team. The treating clinician makes the clinical decisions, and the resident or family is kept informed.
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.