What it is
A surgical site infection is an infection that develops in or around the place where a surgical incision was made. It can involve just the skin, deeper tissue under the skin, or, in some cases, organs or spaces near the surgery. Infections can appear days after a procedure or sometimes later.
Commonly described surgical site infection signs include redness that spreads, warmth around the incision, swelling, increasing pain or tenderness, and drainage that looks like pus or has a foul odor. Fever or chills can also be a sign. An incision that begins to open up or separate may also be a concern.
Some mild redness, tenderness and clear or slightly pink drainage can be part of normal healing, which is why it can be hard to tell the difference at home. Only a licensed clinician can evaluate an incision and determine what is going on.
How it’s traditionally been approached
Traditionally, surgical teams give instructions about keeping an incision clean, protected and monitored during recovery, and they ask patients to report changes. Follow-up visits are often scheduled so the surgeon or care team can look at the site directly.
When an infection is suspected, clinicians commonly examine the wound, review symptoms and medical history, and may take a sample of drainage or order blood work or imaging. Approaches that have long been used by clinicians include opening or cleaning the wound, removing non-healthy tissue, and prescribing medication when appropriate.
Which approach is used depends on how deep the infection is, the person's overall health, and the type of surgery. These decisions belong to the treating clinician after an evaluation, and they differ from person to person.
How the right wound care specialist may help
The right wound care specialist may help by examining the incision, identifying whether the changes look like normal healing or a possible infection, and coordinating with your surgeon. A visit generally includes questions about when symptoms began, any fever, and your health history, followed by a close look at the wound.
If a wound is slow to heal or has opened, a specialist may discuss options such as specialized dressings, debridement, or negative pressure wound therapy, which is a well-established approach. Whether any of these are appropriate is a decision for a licensed clinician after an evaluation, and results are never guaranteed.
Helpful questions to ask a licensed provider include: What is causing my wound? How would you describe its stage or severity? What treatment options exist? How long might healing take? What warning signs should prompt me to call right away? Will my insurance cover the care or supplies discussed?
The whole-person view
Body, mind and stress affect each other during recovery. Worry about a healing incision can disrupt sleep, raise tension and make it harder to follow through on care, while pain, fatigue and limited movement can in turn affect mood.
Some people find body-based support, such as the approaches offered through Somatic Experiences, helpful for working with stress held in the body after surgery or injury. Others find talk therapy through Therapists.plus useful for coping with health anxiety or the emotional side of a difficult recovery. These can complement, not replace, medical care.
Somatic Experiences: trauma and emotional healing →Therapists.plus: mind body connection →
Keep in mind
- Seek medical care promptly for spreading redness, red streaking, increasing warmth or pain, pus, foul odor, fever or chills, or a wound that is rapidly worsening.
- Call 911 or go to the ER for heavy bleeding, exposed bone or tendon, signs of sepsis such as confusion, rapid heartbeat or severe illness, or a deep or severely contaminated wound.
- Licensed professionals should guide all wound and infection care; this page cannot tell you what is right for your wound.
- If emotional distress feels overwhelming or you are in crisis, call or text 988.
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Frequently asked questions
What are the most common surgical site infection signs?
Common signs include spreading redness, warmth, swelling, increasing pain, pus or cloudy drainage, a foul odor, and fever or chills. An incision that opens up can also be a concern. Contact your surgeon or a licensed clinician promptly if you notice these.
How soon do surgical site infection signs appear?
Signs can appear within days of surgery, and sometimes they show up later during healing. Timing varies by person and procedure. If anything seems to be changing or worsening, ask your care team rather than waiting.
Is redness around an incision always an infection?
No, some mild redness and tenderness can be part of normal healing. Redness that spreads, gets warmer, or comes with increasing pain, drainage or fever deserves prompt medical attention. A licensed clinician can tell the difference by examining the wound.
When should I go to the ER for a possible surgical site infection?
Call 911 or go to the ER for heavy bleeding, exposed bone or tendon, signs of sepsis, or a deep or severely contaminated wound. High fever with confusion, a racing heartbeat or feeling severely ill also warrants emergency care. For other signs of infection, seek medical care promptly.
Can a wound care specialist help with surgical site infection signs?
A wound care specialist may help by evaluating the incision, discussing possible causes, and coordinating care with your surgeon. They may talk through options such as dressings, debridement or negative pressure wound therapy when appropriate. What is right depends on your evaluation, and outcomes are not guaranteed.
What should I ask my provider about a possible surgical wound infection?
Ask what is causing the problem, how the wound is staged or described, what treatment options exist, and how long healing might take. Also ask which warning signs mean you should call right away and what your insurance may cover. Writing questions down before your visit can help.
Educational resource. WoundKare shares general information and connects people with independent wound care specialists. It is not medical advice, diagnosis or treatment. Talk with a licensed professional about your health.