About reopened surgical wounds

Any operation can end with a reopened incision, but some people carry more risk than others. Wounds tend to knit more slowly in people living with diabetes, poor circulation, kidney disease or a weakened immune system, and in people who smoke. Extra body weight puts more pull on an abdominal closure and leaves a thicker fatty layer, which has a limited blood supply. Older adults with thin skin, people who were eating poorly before surgery, and people taking steroids long term are also more likely to have trouble. So are those whose operation was an emergency, ran long, or went through an old scar. None of this means dehiscence is certain. It tells the care team whom to watch closely.

What the treating clinician looks at

Part of assessing a dehisced wound is working out why it opened, because the cause changes the plan. If there are signs of infection, the treating clinician decides whether a culture or other tests are needed and raises treatment questions with the surgeon. If fluid had collected under the skin, the wound may drain heavily at first and then settle. If the opening exposes suture material, mesh or an implant, the surgeon needs to know, since that can change whether dressings alone are enough. The clinician also asks about the days before it opened: a coughing illness, a fall, new swelling, or a dressing that stayed wet. Each answer points to something the plan should address.

Care for a reopened surgical wound in Wentzville

Newer subdivisions in Wentzville tend to have two-story homes with the main bedroom upstairs and the laundry a floor away, which matters when the surgeon has limited lifting and stairs. The treating clinician can talk through where rest and dressing changes will happen for now. Senior living communities are part of the picture in outer suburbs too, and we arrange visits there as well as in private homes. With specialists farther away, good communication does more of the work: after each visit, Gateway coordinates an update to the surgical office, so some questions can be settled without a drive.

Where Interstate 64 ends at Interstate 70, at the western edge of St. Charles County, Wentzville has changed from a small town into a fast-growing city. New subdivisions spread in several directions, and beyond them the land opens toward Warren and Lincoln counties. Many specialists’ offices are farther east in the county or across the Missouri River. For a family caring for someone with a wound or a chronic illness, each appointment can mean time off work and a long highway trip. Bringing care to the home or facility takes that trip away.

Care 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.

Care in skilled nursing and assisted living

Assisted living communities differ in how much nursing care they can provide, and an open surgical wound can test those limits. Some have a nurse who can change a dressing daily. Others rely on a home health agency coming in. When a resident’s incision opens, Gateway asks the community what its staff can and cannot do, then arranges the treating clinician’s visits and any outside nursing around that answer. Aides who help with bathing and dressing need the basics from the clinician’s orders as well: how the dressing is protected during a shower, how to avoid pulling on the area during transfers, and whom to tell if it is soaked or loose.

Changes to report

A reopened incision should look a little better, or at least no worse, each time the dressing comes off. Tell the treating clinician or the surgeon’s office promptly if you notice:

  • The gap growing longer, wider or deeper
  • Thick, cloudy or foul-smelling drainage
  • Redness that is spreading outward from the edges
  • A fever, chills or a new sense of being ill
  • Stitches, staples or mesh showing that were not visible before

Call 911 if an abdominal incision bursts open, if anything bulges out through the wound, if bleeding will not stop, or if you have chest pain or trouble breathing.

How primary care fits in

Closing an open surgical wound takes raw material. The body needs enough protein, calories and fluid to lay down new tissue, and appetite is often poor after an operation, especially in older adults. A primary care clinician can look at weight changes, check for problems such as trouble chewing or swallowing, nausea or low mood, and decide whether lab work or a nutrition referral is warranted. Wound drainage itself carries protein out of the body, which adds to the need. Ask before starting supplements, since the right choice depends on kidney function, diabetes and the medicines you take. Arranging wound care and primary care together lets both clinicians work from the same picture.

Primary care at home in Wentzville →

Getting care arranged in Wentzville

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 Wentzville. 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.

When you call about care in Wentzville, have the address, the subdivision name and a nearby cross street, since newer streets are not always on older maps. Also have a phone number, the doctor’s name and any discharge instructions. Gateway coordinates care in Lake St. Louis, O’Fallon, Dardenne Prairie and across St. Charles County too. Wentzville sits at the western edge of the county, so visit availability is confirmed by location and care setting before anything is scheduled.

  • County: St. Charles County, Missouri
  • ZIP codes: 63385
  • Nearby hospitals: SSM Health St. Joseph Hospital in Lake Saint Louis; Progress West Hospital in O'Fallon (not affiliated with Gateway)
  • Nearby communities: Lake St. Louis, O'Fallon, Missouri, St. Charles County, Dardenne Prairie
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Related care in Wentzville

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

Common questions

Will Medicare or my health plan pay for care for a reopened incision in Wentzville?

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 Wentzville, Gateway confirms the treating provider first and suggests you verify benefits with your plan before care starts.

Can I shower with an open surgical wound?

Ask the surgical team or the treating clinician before you do, because the answer depends on how deep the wound is, what dressing is on it and whether a device is attached. Some people are cleared to shower with the dressing protected or just before a scheduled change. Soaking in a bathtub, pool or hot tub is generally off limits until the surgical team says otherwise. Follow the written instructions you were given.

Can physical therapy continue while the incision is open?

Frequently it can, with changes. After a joint replacement or heart surgery, movement is part of recovery, and stopping it completely carries its own risks. The surgeon and the therapist decide which exercises, ranges of motion and weight limits are safe while the wound is open. Let your therapist know as soon as an incision separates, and tell the treating clinician what therapy involves so the dressing can be chosen to stay put.

Can I request care for my mother in Wentzville while I am at work in St. Louis?

Yes. Family members can call Gateway from anywhere, and you do not need to be at the house to start a request. Tell us who will be home for the visit and the best number to reach you during the day. We coordinate scheduling around the household and, with your mother’s permission, update you 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.