Infection - surgical wound; surgical site infection - SSI
Surgery that involves a cut (incision) in the skin can lead to a wound infection after surgery. Most surgical wound infections show up within the first 30 days after surgery.
Surgical wound infections may have pus draining from them and can be red, painful or hot to touch. You might have a fever and feel sick.
Surgical wounds can become infected by:
You are more at risk for a surgical wound infection if you:
There are different levels of wound infections:
Antibiotics are used to treat most wound infections. Sometimes, you also may need surgery to treat the infection.
You may be started on antibiotics to treat the surgical wound infection. The length of time you will need to take the antibiotics varies, but will be for at least 1 week . You may be started on IV antibiotics and then changed to pills later. Take all of your antibiotics, even if you feel better.
The pus from your wound may be tested to figure out the best antibiotic. Some wounds are infected with methicillin-resistant Staphylococcus aureau (MRSA), which is resistant to commonly used antibiotics. A MRSA infection will need a specific antibiotic to treat it.
INVASIVE SURGICAL TREATMENT
Sometimes, your surgeon needs to do a procedure to clean the wound. They can take care of this either in the operating room or in your hospital room. They will:
Your surgical wound may need to be cleaned and the dressing changed on a regular basis. You may learn to do this yourself, or nurses may do it for you. If you do this yourself, you will:
To help some surgical wounds heal, you may have a wound VAC (Vacuum Assisted Closure) dressing. It increases blood flow in the wound and helps with healing.
It may take days, weeks, or even months for the wound to be clean, clear of infection, and finally heal.
If the wound does not close by itself, you may need a skin graft or muscle flap surgery to close the wound. If a muscle flap is necessary, the surgeon may take a piece of muscle from your buttocks, shoulder, or upper chest to put over your wound. If you need this, the surgeon will not do this until after the infection has cleared.
GOING HOME OR TO A SKILLED NURSING FACILITY
You may need to spend at least a few days in the hospital. After that, you will either:
Call your doctor if your surgical wound has any signs of infection:
Anderson, D.J. Surgical site infections. Infect Dis Clin N Am. 2011; 25(1): 135-153.
Kulaylat MN, Dayton MT. Surgical Complications. in: Townsend CM, Beauchamp RD, Evers BM, Mattox, KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 13.
Last reviewed on: 9/1/2014
Reviewed by: Joshua Kunin, MD, consulting colorectal surgeon, Zichron Yaakov, Israel. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.