Care for a reopened surgical wound in Webster Groves.

What to know about reopened surgical wounds

Once an incision has opened, the usual path is what clinicians call healing by secondary intention. Instead of the edges being joined, the gap fills from the base with new red, bumpy tissue, the wound draws inward, and skin grows across from the sides. That happens in stages over weeks, and for larger or deeper openings it can run into months. Early on, drainage may be heavy and dressing changes frequent. As the wound fills, drainage usually lessens and the opening measures smaller. Progress is rarely a straight line. A wound may stall, form a pocket under one edge, or need unhealthy tissue cleared before it moves again. The scar that results is often wider than the original line.

How the care plan is built

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.

Care for a reopened surgical wound in Webster Groves

People in Webster Groves who have a joint replacement or major abdominal surgery often spend a stretch in a nearby skilled nursing or rehabilitation center before returning home. A dehisced wound has to be followed across that move. Gateway coordinates so that the measurements, current dressing orders and the surgeon’s instructions go with the patient from the facility to the house, or from an independent apartment in a senior living community to its care wing. Supplies are a frequent gap on the day of discharge, so we confirm what is being sent home and what still needs to be ordered.

Tall trees, deep front porches and houses that have stood for a century give Webster Groves its look. The city lies along Interstate 44 in St. Louis County, with Lockwood Avenue running through its center and Kirkwood, Shrewsbury and Crestwood nearby. Many residents have been here for decades and have no plans to leave. Those same older homes can be hard on someone with a leg wound or a recent surgery, since many have steps at every door. Arranging care at home, or in a nearby facility, spares the patient that climb.

At home between visits

Supplies for an open surgical wound add up quickly: packing or filler material, cover dressings, tape or wraps, wound cleanser and gloves. Once the treating clinician writes the orders, Gateway coordinates the supply request so the ordered items can be sent to the house, and updates it when the orders change. Running out over a weekend is a common and avoidable problem, so tell us when you are down to a few days of dressings. The house itself matters too. A bed that is hard to get out of, a low chair or a laundry basket that needs carrying can all strain a fresh abdominal or hip incision. Mention those obstacles during the visit.

In a facility

In a facility, wound orders live in the resident’s chart and go through the attending physician. A partner clinician who visits for a reopened incision documents the assessment, recommends or writes orders according to the facility’s process, and leaves clear instructions for the nurses who will do the dressing changes. Gateway handles the scheduling with the nursing leadership, requests surgical records the facility may not have received, and coordinates with the surgeon’s office about follow-up appointments. That last piece matters, because a trip out to the surgeon means transportation, an escort and a dressing that will hold up through the ride.

Changes to report

Whoever looks after the wound, whether family at home or nurses in a facility, should know which findings cannot wait for the next scheduled visit. Report to the treating clinician:

• Wound edges that were pink turning dark, gray or black
• A pocket or tunnel that is new or deeper
• A sudden increase in drainage or a strong odor
• Fever, chills or a racing heartbeat
• A wound therapy pump that alarms repeatedly or loses its seal

Call 911 when an abdominal wound separates widely or its contents push through, when bleeding will not stop, or when there is chest pain, labored breathing, collapse or sudden confusion.

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 Webster Groves →

Getting care arranged in Webster Groves

You may already have a surgeon, a wound clinic or a home health nurse and still want help with care for a reopened surgical wound closer to home in Webster Groves. That is a fine reason to call 314-325-0126. Tell us who is treating the wound now and what is not working, whether that is the travel, the gaps between appointments or unclear instructions. Gateway does not replace your current clinicians. We can arrange for a partner clinician to see the wound where you live and, with your permission, share notes with the offices already involved so the plans agree.

Families arranging care in Webster Groves should have the address, a phone number, the patient’s regular doctor and a list of current medications on hand when they call 314-325-0126. Mention which entrance has the fewest steps. We coordinate care in nearby Kirkwood, Shrewsbury, Maplewood, Brentwood, Crestwood and Affton as well, so a move to a relative’s home or a facility close by need not mean starting over. Availability is confirmed by location and care setting.

• County: St. Louis County, Missouri
• ZIP codes: 63119
• Nearby hospitals: SSM Health St. Mary's Hospital in Richmond Heights; St. Luke's Des Peres Hospital; Mercy Hospital South (not affiliated with Gateway)
• Nearby communities: Kirkwood, Shrewsbury, Maplewood, Brentwood, Crestwood, Affton
• Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Other conditions and nearby communities

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

• Diabetic foot ulcers
• Venous leg ulcers
• Pressure injuries and bed sores
• Arterial and mixed wounds
• Non-healing wounds
• Post-surgical wounds
• Surgical site infections
• Skin tears and traumatic wounds
• Wounds with lymphedema
• Skin graft aftercare
• Wound VAC (NPWT) follow-up
• Care for a reopened surgical wound in Kirkwood
• Care for a reopened surgical wound in Affton

Common questions