Surgical wound infection

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at November 30, 2016
StartDiseasesSurgical wound infection

Surgical wound infections can happen to anyone who has had surgery, even if the utmost care is taken. While infection is more likely among people with certain risk factors, everyone should be aware of the signs and symptoms of these infections that follow surgery. Treatment can be straightforward, and prognosis can be good if the infection is addressed promptly.


Definition & Facts

Surgery, whether major or minor, usually requires some sort of opening in the skin. Any time the skin is broken, it is possible for pathogens to enter. Thus, after having any type of surgery which involves an incision of some sort, it is possible for the surgical wound to become infected.

Proper wound care is essential, but it does not necessarily ensure that an infection will not occur. In the best case scenario, in which all precautions are taken and protocols are followed, an individual still has a one to three percent chance of developing a surgical wound infection.

Symptoms & Complaints

A patient who develops a surgical wound infection is likely to notice some important signs and symptoms that should be acted upon right away. First, a patient may notice an overall feeling of malaise. While the tiredness and lethargy may simply be a symptom of having had surgery, a person with an infection will notice that they are getting progressively worse instead of better each day.

A fever is another common sign that infection may be present, especially if it is 101 degrees Fahrenheit or more. The patient may also have chills and a headache. A cloudy, greenish, or foul-smelling drainage from the surgical site can be another indication of an infection.

In addition, redness, swelling, or pain that does not seem to be getting any better are also all indicators of an infection. While a surgical incision will likely be painful for some time after the operation, there should also be noticeable improvement as the days pass. Finally, if the site of the incision is warm or hot, it is a telltale symptom that infection is likely to be present.


Surgical wound infections are caused by germs. Since the skin is the body’s natural barrier to germs, when it is broken, such as during a surgical procedure, it is easier for germs to get into the body. Thus, the body becomes more susceptible to developing an infection after surgery.

The most common type of pathogen to cause a surgical wound infection are bacteria such as staphylococcus, streptococcus, and pseudomonas. These can enter the body from a number of different sources including the touch of a caregiver, a surgical instrument, bacteria that is already present in the body that are then spread in the wound, or germs simply found in the air.

Certain people are also more likely to experience surgical wound infections than others. They include those who:

Diagnosis & Tests

Diagnosis of a surgical wound infection is usually done by sight. That is, a doctor can look at a wound and visually see that it is infected in most cases. An infected wound will typically look red, swollen, and may drain pus that is discolored. In addition, the wound and the surrounding area will likely feel warm or hot to the touch as the body tries to fight off the infection.

The doctor may order blood tests to check for elevated white blood cell counts which would indicate infection somewhere in the body. In addition, the pus that drains from the wound can also be captured and tested. This type of testing will be done in a lab and can tell the doctor exactly which kind of germ is causing the infection. This information will help the doctor to know what type of antibiotic will be best in treating the infection. Since some bacteria are meticillin resistant, the doctor will know from the results, and prescribe the appropriate antibiotic medication for this case.

Treatment & Therapy

Treating a surgical wound infection usually only requires a patient to take antibiotics. If the patient is still in the hospital, the antibiotics may be administered intravenously and then later prescribed as an oral medication. It is important to take the entire course of the antibiotics, even if the wound seems to be getting better. A patient will usually take antibiotics for at least a week, and it can be a longer period in some cases.

In some cases, the doctor may need to do a surgical procedure to clean out the surgical wound. The doctor will remove any surgical sutures or surgical staples, clean out the wound with saline solution, drain any abscesses, and clean off any dead skin. The wound will then be packed with the appropriate gauze, and a dressing will be applied. The patient or a caregiver may then have to change the dressing according to specific instructions to assure that the wound stays clean and does not get re-infected.

Prevention & Prophylaxis

Prior to having surgery, a person can ask their doctor about precautions they can take to help reduce the chance of infection. A patient should be sure to share their medical history, medications, and any other pertinent information with their doctor, especially if they have a chronic condition such as diabetes.

In addition, it is helpful to stop smoking prior to surgery. After surgery, visitors should not touch the surgical site and all care should be taken when a caregiver changes a dressing to ensure the highest cleanliness standards. It is also important to follow all of the doctors instructions for caring for the wound and take any prescribed medications, particularly antibiotics, if they are prescribed.