Infections after surgery


One of the most serious complications of an operation is an infection. Having an operation increases your risk of infection in a number of ways.

An incision makes it possible for bacteria to get through the protective layer of your skin and cause a wound infection. But having surgery can also mean having temporary catheters, breathing tubes, and drains that can introduce bacteria into places they’re not normally supposed to be. And surgery is tough on your body, so your immune system can be knocked down for a few days afterward, making infections more likely.

That said, most operations have a very low infection rate – 1% or less. Even operations on parts of your body with lots of bacteria in them, such as the intestine, usually have wound infection rates of no more than 1 in 10 to 1 in 20 patients. So how do you avoid being one of the unlucky few?

While it’s not possible to completely eliminate your risk of a wound infection, there are some things you can do to minimize it.

What You Can Do Before Your Operation

  • Do not shave the skin over the area of your operation. Some patients shave their body hair over the area of the incision. While you might think that this would make things easier for your surgeon, the reality is that razors cause nicks in the skin that increase the risk of infection. In the operating room, we have specially designed clippers that cut hair short without damaging the skin underneath, so let us be your barber.
  • Wash with chlorhexidine the day before your operation, if your surgeon recommends it. Your surgeon may provide you with a special soap called chlorhexidine for your bath or shower the night before surgery. Chlorhexidine is a high-powered antimicrobial soap, which means that using it before surgery helps reduce the number of bacteria on your skin (a stronger version is often used on your skin in the operating room, and your surgeons use it to scrub their hands before the operation, too.) You don’t need to go overboard – one good wash is enough.

What You Can Do At the Hospital

  • Remind your medical team about pre-operative antibiotics. Most patients get antibiotics in the operating room, right before the operation starts. This should be part of the standard pre-op checklist that the medical team in the operating room completes before surgery. But you can help by asking your surgeon or anesthesiologist what their plan for antibiotics is, and reminding them if you have any medication allergies. There’s no benefit to taking antibiotics before you enter the operating room, and unless specifically instructed by your surgeon, you shouldn’t continue taking them after your operation, either. Doing so can actually increase your risk of getting a drug-resistant infection.
  • Don’t have an elective operation when you’re sick. If you’re already feeling under the weather, don’t have an operation that isn’t urgent. If you have a fever, cough, cold, or urinary tract infection, or any active skin infection, call your surgeon to talk about rescheduling your operation.

What You Can Do After Your Operation:

  • Don’t take soaking baths. The skin of your incision needs time to rebuild its waterproof seal. Generally skin is sealed enough for you to safely get it wet in a shower after 48 hours. But soaking in a bath, pool, or hot tub within the first 10-14 days after surgery can break down your healing incision and let bacteria in. So limit yourself to showers or sponge baths for the first two weeks after your operation.
  • Keep incisions open to air after 48 hours. Once your incision has formed a watertight barrier – which usually takes a couple of days – having it dry and open to the air is actually the best way to help it heal and prevent moisture from causing skin breakdown and infection. Follow your surgeon’s instructions for when to take your bandage off. Once it’s off, if you want to cover your incision to keep it from rubbing on or staining your clothes, use a breathable gauze dressing.
  • Get disconnected. Depending on the kind of operation you have, you may come out of your operation with a bladder catheter, epidural catheter, and/or a drain in place. These are all important tools to keep you comfortable and speed your recovery. But each one also brings with it a risk of infection. You can help your medical team by asking about their plan for any catheters you have, and by reminding them that you’d rather have them out as soon as possible.
  • Take deep breaths, get up, and walk. One of the worst infections you can get after an operation is pneumonia. It’s caused by parts of your lung collapsing, usually because you’re taking shallow breaths (sometimes because of pain, sometimes because of anesthetics) and spending the whole day lying in bed. As soon as you can, try to take good deep breaths several times every hour, and practice coughing. And as soon as your medical team allows it, try to get up into a chair or, better yet, go for a walk (get your nurse to help you, at least for the first few outings).

Taking these patient safety steps will not completely eliminate your risk of developing a post-operative infection, but they will all help reduce the risk.

How do you know if you have an infection? And what should you do if you get one? Check back here soon to find out – my next post will have all those details.

Disclaimer: Keep in mind that the information in this blog is not intended to be medical advice. It’s important to follow the instructions and guidance of your doctor and healthcare team, which might be different than the information provided here.

This story originally appeared in the Health Dialog Care Compass blog.

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