Surgical wounds and preventing infections

About wound infections

There are many tiny germs (known as micro-organisms) living on your skin, in your body and in the environment around you. Most do not cause you any harm, but during surgery these micro-organisms can enter your body through the cut (incision) made by the surgeon. The germs can then multiply and cause an infection.

Many infections only affect the skin around the wound, but some can be more serious if they affect the deeper tissues such as muscle or bone.

When do wound infections develop?

Wound infections can develop any time from 2 to 3 days after your operation until the wound has healed (usually 2 to 3 weeks after your operation).

Occasionally, an infection can occur a few months after an operation. This is usually when an artificial implant has been used, such as a hip replacement.

Some types of surgery have more risk of infection than others. This is because of the risks from different types of germs. Infections are more likely to happen after surgery on parts of the body that have lots of germs, such as the gut.

What increases the risk of a wound infection?

You are more likely to develop a wound infection if you:

• have diabetes
• are a smoker
• take steroids
• have a poor diet
• have been unwell in hospital for a long time before your operation
• were cold before and after your operation
• are overweight

What can I do to help reduce the risk?

• Have a bath or shower the day before you come into hospital. If you are not able to do this, please let a member of staff know when you are admitted so that we can help you to have a wash. Pay special attention to any areas that can get hot and sweaty, for example; arm pits, groin and under folds of skin. Use clean towels to dry yourself, put on clean clothes and sleep in clean bed linen.
• Do not shave the hair around the site of the operation in the few days before your operation– this will be done by your surgical team if needed on the day of the operation (in the operating suite).
• Keep warm: wear warm clothes into hospital and bring clothes with you that will keep you warm during your stay (such as slippers, a dressing gown and a vest). Tell the staff looking after you if you feel cold. They will make sure that you are kept warm before and after your surgery. Research has shown that the risk of infection is reduced if you keep warm.
• After your operation do not take off the dressing or touch your wound. Follow the instructions given to you by your surgical team.
• Do not let your family and visitors touch your dressing or wound in hospital or when you are discharged home.

What will the staff do to help reduce the risk of me developing a wound infection?

• You may be given antibiotics before, during or after your operation to further reduce the risk of developing an infection.
• Your skin will be cleaned with an antiseptic solution in the operating theatre before the cut is made.
• Staff in the operating theatre will cover their hair, clean their hands and forearms and wear face masks, sterile gowns and gloves.
• Throughout your stay all staff will clean their hands before touching you or your wound, either by using alcohol hand sanitiser or washing with soap and water.
• Staff will regularly check your temperature before, during and after your operation.
• You should be given enough bedclothes to ensure you are comfortably warm, please let staff know if you feel cold at any time.

All patients are nursed with care to avoid germs getting into the wound or any other area, such as a catheter or drain (where a tube is used to drain away fluid).

How would I know if I have a wound infection?

While you are in hospital, the nurse who changes your dressing will check your wound for any signs of infection.

If the nurse or doctor thinks that you have a wound infection, they may take a sample from the surface of the wound with a swab. They will then send this sample to the laboratory for tests.

If you are concerned about your wound, tell the nurse looking after you.

The nurse or doctor looking after you will explain how to look after your wound before you leave the hospital.

What happens after I leave hospital?

You may have an infection if you notice any of the following symptoms:

• The skin around your wound becomes red, swollen, hot or painful.
• Your wound has a green or yellow coloured discharge (pus).
• Your wound opens.
• You feel generally unwell, feverish or you have a high temperature.

If you have a problem with your wound or you develop any of these symptoms after leaving hospital, contact your GP or NHS 111 for advice straight away, unless you have been told to contact the hospital.

If you have been given a specialist contact telephone number, for example patients having orthopaedic surgery will be given a letter with the contact details of the Orthopaedic Advanced Nurse Practitioner, please use this number as your first point of call if you have any concerns.

It is important to treat any infection as soon as possible to stop it getting worse.

Improving our care

About a month after your operation, we might send you a questionnaire or phone you to ask if you had any problems with your wound. This information will help the hospital staff to improve the way we do things. Some of this information might be given to the UK Health Security Agency. We do not share any information that can be used to identify you, such as your name, address or postcode.