About post-surgical wounds

In the first days, an incision is usually tender, slightly swollen and pink along its edges, and it may leak a little clear or pale pink fluid. Over the following weeks the surface seals, a firm ridge often forms underneath, and stitches or staples come out when the surgeon says so. The scar then keeps remodeling for many months, slowly flattening and fading, and it stays weaker than uninjured skin for a long time. Wounds left open follow a different path: they fill with new red tissue from the bottom and shrink gradually. Problems tend to show up in the first few weeks, though an incision can open or drain later, especially after strain or an infection.

How the care plan is built

Some surgical wounds need more than a dressing, and the treating clinician decides when that is the case. Depending on the findings, orders may include:

  • A culture or lab work if infection is a concern
  • A different dressing to manage heavier drainage
  • A negative pressure device, when the surgeon agrees
  • A return to the surgeon for imaging or a procedure

Gateway’s role is the practical side of those orders: getting the request to the right office, tracking supplies and equipment, and confirming that the result or the reply comes back to the clinician who asked for it.

Arranging this care in Wildwood

From Wildwood, the surgeon’s office may be a long drive, and sitting in a car for an hour is hard on a fresh abdominal, hip or back incision. Wound follow-up at home between surgical appointments reduces those trips, and the treating clinician’s notes go to the surgeon so in-person visits can be saved for when they are needed. Adult children who commute are often the caregivers here. Gateway shares visit times ahead and passes updates by phone, so a daughter or son at work knows what the clinician found.

Homes in Wildwood range from houses on several wooded acres at the end of a long driveway to conventional subdivisions and the more compact streets around the town center. Senior living, including assisted living and memory care, is found in Wildwood and in nearby Ellisville, Ballwin and Chesterfield. Gateway arranges visits with partner clinicians in private homes and facilities alike. For rural addresses we ask about gates, driveway conditions and pets, so the clinician arrives prepared and nobody is surprised at the door.

Care at home

Supplies are where home recovery often goes wrong. The hospital sends you home with a few days of dressings, and then the gauze, tape or drain supplies run out over a weekend. Once the treating clinician writes an order, Gateway follows up with the supplier so the right items in the right sizes arrive before they are needed, and we check again when the order changes. If a negative pressure device is part of the plan, we help coordinate delivery, canister and dressing-kit resupply, and the question of who changes it.

In a facility

Many people go from the hospital to a rehabilitation or skilled nursing stay after joint replacement, heart surgery or abdominal surgery. There, facility nurses do the daily dressing changes and therapists get the patient moving. A treating clinician arranged through Gateway assesses the incision on site, writes wound orders for the nursing staff to carry out and documents findings in a form the facility can file in its chart. The attending physician remains in charge of overall medical care, and the surgeon is kept informed of anything that departs from the expected course.

Signs to tell the clinician about

For a caregiver, the first hint of a wound problem is often the person, not the incision. Tell the treating clinician if you notice:

  • A temperature above the level named in the discharge papers
  • New tiredness, poor appetite or nausea
  • Swelling, hardness or a bulge beside the incision
  • A new smell when the dressing comes off
  • Skin around the tape turning red, blistered or raw

Call 911 right away for sudden confusion, fainting, a racing heartbeat with shaking chills, difficulty breathing, chest pain, or a wound that has split open or is bleeding heavily.

How primary care fits in

Surgery stresses the body, and blood sugar often runs higher than usual in the weeks afterward, even in people whose diabetes was steady before. High readings slow tissue repair and make infection more likely. The surgeon manages the operation, but day-to-day glucose monitoring and diabetes medicines usually belong to primary care. When Gateway arranges both wound follow-up and primary care, the clinician watching the incision and the clinician managing blood sugar can share what they see, so a stalled wound and a run of high readings are looked at together instead of weeks apart.

Primary care at home in Wildwood →

How to get started in Wildwood

Clinicians and facility staff referring a patient for post-surgical wound care in Wildwood can call 314-325-0126 or fax 314-786-7966. Helpful to include: demographics and insurance, the working diagnosis, recent wound notes and measurements, current orders, the medication list and relevant test results. Please also tell us who should receive the treating clinician’s notes afterward. The online referral form takes contact details only, so clinical records should come by fax, not through the form. Gateway confirms that the referral arrived, checks availability for the patient’s address and lets your office know what has been scheduled.

St. Luke’s Hospital in Chesterfield and Mercy Hospital St. Louis in Creve Coeur are hospitals Wildwood residents commonly use, and both are a meaningful drive from the western parts of the city. Gateway is not affiliated with either hospital. Returning for wound checks after a discharge can be tiring for the patient and the driver. Families can call us once a discharge date is known, and hospital discharge planners can refer directly. We gather records and orders and arrange follow-up with a partner clinician at home or in a facility.

  • County: St. Louis County, Missouri
  • ZIP codes: 63005, 63011, 63021, 63038, 63040
  • Nearby hospitals: St. Luke's Hospital in Chesterfield; Mercy Hospital St. Louis in Creve Coeur (not affiliated with Gateway)
  • Nearby communities: Chesterfield, Chesterfield and West County, Ballwin, Ellisville, Eureka, Franklin County
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

More wound care in Wildwood

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

Common questions

Do I need a referral from my surgeon to arrange wound follow-up in Wildwood?

No. Patients, family members and caregivers can call Gateway directly, and surgical offices and discharge planners can refer as well. Once you call, we ask for permission to request the operative report and discharge instructions, because the treating clinician needs the surgeon’s orders before making decisions about the incision. Some health plans have their own referral rules, which we help you check.

Why does my incision itch, feel numb or have a hard ridge under it?

Itching, patches of numbness and a firm ridge beneath the scar are common as an incision heals, because small nerves were cut and new tissue is forming. They usually ease gradually. Mention them at your next visit. Report them sooner if itching comes with a rash or blisters under the dressing, or if the firm area becomes larger, red, hot or painful.

The incision opened a little at one end. Is that an emergency?

A small, shallow gap with little drainage is usually not an emergency, but report it to the surgeon’s office or the treating clinician promptly so someone can look at it. Keep it covered the way your discharge instructions describe, and do not try to close it yourself. Call 911 if the wound opens widely, if you can see deep tissue, or if bleeding does not stop with firm pressure.

Can Gateway help with a ride from Wildwood when a test cannot be done at home?

Yes. When the treating clinician orders something that has to happen at a hospital or an office, such as imaging or a specialist visit, Gateway can help coordinate the appointment and the transportation arrangements. Whether a ride is paid for depends on the plan and the situation, so we will go over what to ask your insurer.

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.