What to know about surgical site infections

Every incision breaks the skin, the body’s main barrier against bacteria. Surgical teams lower the risk with skin cleansing, sterile technique and, for many operations, an antibiotic given shortly before the first cut. Even so, some bacteria reach the wound, most often from the patient’s own skin or, in bowel surgery, from the gut. Whether they take hold depends on how many there are and how well the tissue can defend itself. Tissue with poor blood flow, a collection of blood or fluid under the skin, or foreign material such as mesh gives bacteria a place to settle. Careful practice lowers the risk but cannot remove it, which is why the first weeks after any operation call for a close eye on the incision.

How the care plan is built

The wound is only part of the assessment. The treating clinician also asks about pain, appetite, bowel changes since the antibiotic began, and how well you are moving around. Temperature and pulse are noted. If the incision is on the abdomen, the clinician considers strain from coughing or lifting. If it is on a leg, swelling and circulation get attention. The clinician then decides who should hear about what, such as the surgeon for a suspected deep pocket or the primary care clinician for poor eating and drinking. The plan names what will be checked at each visit and what result would prompt a call.

Arranging this care in Wildwood

Newer subdivisions and growing senior living communities in Wildwood 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.

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

Recovering from an operation at home already means lifting limits, less driving and a body that tires quickly. An infection adds surgeon rechecks, sometimes lab work, and a wound that has to stay dressed. Bringing wound visits to the house removes some of those trips. For appointments that still have to happen in person, such as a recheck with the surgeon, Gateway can help with transportation arrangements and send the latest wound notes to the office beforehand. If home health is already coming for therapy or nursing, we coordinate so the wound orders reach that agency and the two schedules do not collide.

In a facility

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

An infection that was settling can flare again, and the first clues are not always at the incision. Tell the treating clinician or the surgical team promptly about:

  • A temperature above the level your surgeon told you to report
  • Shaking chills or drenching sweats
  • Pain that climbs after days of easing
  • Nausea, poor appetite or unusual tiredness that is new
  • Blood sugar readings running higher than usual, if you check them

Call 911 if the person becomes confused, is hard to wake, breathes fast or with effort, has a racing heartbeat, or faints. Those signs can mean the infection is spreading through the body.

Why primary care matters here

Surgeons follow a patient for a set period after an operation. Primary care stays on. That longer view matters when a surgical site infection is only one of several things going on: leg swelling from heart or vein problems around a lower-limb incision, poor circulation, a chronic cough that strains an abdominal wound, or weakness that keeps someone in bed and at risk for pressure injuries. A primary care clinician manages those conditions and coordinates with the surgeon about activity. For people who cannot easily get to an office, Gateway can arrange primary care visits in the same setting as the wound visits.

Primary care at home in Wildwood →

Arranging wound follow-up after a surgical site infection in Wildwood

If you have been managing a wound mostly on your own and are looking for wound follow-up after a surgical site infection in Wildwood, you can call Gateway yourself at 314-325-0126. Tell us what the wound looks like now, what the last clinician said about it and what is getting harder to manage. It helps to know the patient’s insurance and the names of the doctors involved, but do not wait until you have everything. We check whether a partner clinician can see the patient at home or in their facility, and we tell you what we find. The treating clinician takes it from there, and you stay part of the conversation.

Three things help when calling from Wildwood: the full street address, clear directions if the home is off a private road or a long way from the nearest highway, and the name of the patient’s doctor along with any recent hospital paperwork. Gateway also coordinates care in Chesterfield and West County, Ballwin, Ellisville, Eureka and Franklin County. Because Wildwood is spread out, availability is confirmed by location and care setting, and an exact address lets us plan the visit properly.

  • 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 surgical site infections, or see everything Gateway arranges on the mobile wound care in Wildwood page.

Common questions

Can a clinician come to a home in Wildwood 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 Wildwood 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.

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.

Does Gateway arrange surgical site infection follow-up in nursing and rehabilitation facilities in Wildwood?

Gateway arranges wound visits in skilled nursing facilities, rehabilitation centers, assisted living and memory care, as well as private homes. In a facility, the treating clinician works with the nursing staff and the attending physician under the facility’s own procedures. Facility staff or family can contact us to ask whether a partner clinician is available at a particular building in Wildwood.

Which ZIP codes in Wildwood does Gateway coordinate care in?

Wildwood addresses fall in five ZIP codes: 63005, 63011, 63021, 63038 and 63040. Several are shared with neighboring cities such as Chesterfield, Ballwin and Ellisville, where Gateway also coordinates care. Rather than relying on the ZIP code alone, give us the street address and we will confirm availability for that location and care setting.

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.