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

Early on, the treating clinician and the surgical team agree on where the wound is headed. Some infected incisions are left to close on their own from the base. Others are kept clean until the surgeon can stitch them shut. A few need more surgery before either can happen. The goal shapes the plan: which dressings are used, how often the wound is measured and what the surgeon wants reported. The clinician also sets markers of progress, such as less drainage, a shallower base and healthy red tissue. When a wound misses those markers over several visits, the plan is reviewed with the surgeon instead of simply continued.

Arranging this care in St. Peters

From St. Peters, the surgeon’s office and the hospital where the operation took place can be a long drive, and sitting in a car is uncomfortable with a sore, draining incision. Wound follow-up at home reduces how often that drive is needed. Many family caregivers here commute, so a daytime dressing change may fall when no one else is in the house. Tell us who is home and when. Gateway works with the treating clinician and, if ordered, home health to plan for the changes a working family cannot do.

Most people in St. Peters live in single-family subdivisions, and many of those houses are split-level or two-story, with the bedrooms up a flight of stairs. There are also apartment complexes, condominiums, villas for older adults, assisted living, memory care and skilled nursing facilities. Gateway arranges visits with partner clinicians in any of these settings. For a home visit we confirm the address and who will be there. For a facility visit we work with the nursing staff on timing, records and orders so the visit fits the resident’s day.

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.

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.

Signs to tell the clinician about

Caregivers of older adults should know that infection does not always announce itself with fever. In a person who is frail or has dementia, report any of these to the treating clinician:

  • New confusion, restlessness or sleepiness
  • Refusing food or fluids
  • Guarding the surgical area or crying out when it is touched
  • A dressing that is suddenly wet, stained or strong smelling
  • A new fall or sudden weakness

After surgery on a leg or hip, also report new calf pain or swelling. Call 911 for chest pain, severe shortness of breath, a person who cannot be roused, or bleeding that will not stop.

How primary care fits in

A new antibiotic joins whatever else you take, and the combination deserves a look. Some antibiotics change how other medicines act, blood thinners among them, and some are cleared by the kidneys, which matters for older adults. Pain medicine after surgery can cause constipation and drowsiness, and steroids or other immune-suppressing drugs can slow wound healing. Sorting this out is primary care work. A primary care clinician can review the full list, including what the hospital added or stopped, and raise concerns with the surgeon or prescriber. When Gateway arranges both kinds of care, the wound clinician’s findings reach the clinician reviewing the medicines.

Primary care at home in St. Peters →

How to get started in St. Peters

People asking about wound follow-up after a surgical site infection in St. Peters 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.

Before calling Gateway at 314-325-0126, gather a few things: the St. Peters street address, a good callback number, the name of the patient’s doctor, and discharge papers if there was a recent hospital or rehab stay. An insurance card is useful for coverage questions. We also coordinate care in St. Charles, O’Fallon, Cottleville, Weldon Spring and elsewhere in St. Charles County. Visit availability is confirmed by location and care setting, so tell us whether the patient is at home or in a facility.

  • County: St. Charles County, Missouri
  • ZIP codes: 63376
  • Nearby hospitals: Barnes-Jewish St. Peters Hospital; SSM Health St. Joseph Hospital in St. Charles; Progress West Hospital in O'Fallon (not affiliated with Gateway)
  • Nearby communities: St. Charles, O'Fallon, Missouri, Cottleville, Weldon Spring, St. Charles County
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Other conditions and nearby communities

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

Common questions

Can a clinician come to a home in St. Peters 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 St. Peters 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.

Will my insurance pay for wound follow-up visits in St. Peters 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.

How long will an infected surgical wound take to close?

No one can give an exact date. It depends on how deep and wide the opened area is, whether the infection is fully controlled, where on the body it sits, and your general health. A better question for the treating clinician is whether the wound is moving in the right direction: smaller measurements, less drainage and healthy tissue at the base from one visit to the next.

What should a St. Peters family do when a relative comes home from the hospital with a surgical wound?

Follow the written discharge instructions and keep the follow-up appointments the hospital scheduled. If getting to those visits will be difficult, call Gateway. We can arrange a visit with a partner clinician at the St. Peters home, gather the hospital records and coordinate orders. The treating clinician decides how the wound is cared for and how often it is checked.

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.