Signs of Wound Infection After Surgery: When to Call Your Surgeon
A patient guide from Dr Devesh Kaushal — Specialist General Surgeon, Campbelltown
Wound Infection After Surgery — What to Look For
Most surgical wounds heal without complications. However, wound infection — also called surgical site infection — is one of the more common post-operative complications, and knowing the warning signs means it can be identified and treated early, before it becomes serious.
The key to early identification is knowing the difference between what is normal in a healing wound and what is a sign that something is wrong. Many patients worry about their wound in the first days after surgery — often when the wound looks and feels exactly as it should. This guide explains what to look for, when to contact the rooms, and when to seek urgent care.
The most important rule: Wound infection signs that are getting worse — not better — over time always warrant medical review. If in doubt, call the rooms on (02) 7906 8312. Wound infections are straightforward to treat when caught early. |
Normal vs Abnormal — Know the Difference
✔ Normal — Expected After Surgery | ✘ Abnormal — Contact the Rooms |
• Mild to moderate pain and discomfort at the wound — improving day by day • Narrow rim of pink or red immediately around the wound edges in the first 2–3 days • Swelling and puffiness around the wound in the first few days • Bruising around the wound — may extend some distance from the site • Small amount of clear or pale pink fluid under the dressing in the first 24–48 hours • Itching around the wound from day 3 onwards | • Redness spreading outward beyond the wound edges — and getting worse • Pain that is increasing after day 2–3, or returning after initially improving • Increasing warmth and swelling after day 3 rather than settling • Yellow, green or cloudy discharge from the wound • Foul smell from the wound • Fever above 38°C • The wound edges separating or opening |
The 6 Signs of Wound Infection — Explained
The following are the key signs that a wound may be infected. Each is explained to help patients identify them clearly.
🔴 | Spreading redness A narrow pink rim immediately around the wound in the first 2 days is normal. Infection shows as redness that spreads outward from the wound edges — like a ring expanding around the wound — particularly if it is darker, warmer and more prominent than on the previous day. Use a pen to draw around the redness border and check 4 hours later — if it has expanded, seek assessment promptly. |
🌡️ | Fever A temperature above 38°C in the first two weeks after surgery can indicate a wound infection — particularly when accompanied by other wound signs. Take your temperature with a thermometer if you feel feverish. A fever alone, without wound signs, can have other causes after surgery (including chest infection or urinary tract infection). Contact the rooms if you develop a fever. |
💧 | Discharge from the wound A small amount of clear or pale pink watery fluid from the wound in the first 24 to 48 hours can be normal. Discharge that is yellow, green, cloudy, or thick — or that has a foul smell — indicates infection. Any discharge that is increasing in volume rather than settling should be assessed. Do not squeeze or probe the wound. |
🔥 | Increasing warmth and swelling Some warmth and swelling around the wound in the first 2 to 3 days is expected as part of the normal inflammatory healing response. After day 3, the wound should progressively feel less warm and swollen. Increasing warmth, swelling or firmness after the initial settling period is a sign of possible infection. |
⚡ | Worsening pain Wound pain should gradually improve from day 2 to 3 after surgery. Pain that increases after initially settling — or that requires more pain relief than before — is abnormal. Worsening pain at the wound, particularly if accompanied by redness or discharge, should be assessed promptly. |
🔓 | Wound opening The wound edges should stay together and progressively heal. If the wound edges begin to separate — or the wound opens — contact the rooms immediately. Do not try to close the wound yourself or apply any dressings beyond covering it loosely with a clean cloth. A wound that has opened needs clinical assessment to determine the cause and appropriate management. |
When to Contact the Rooms vs When to Go to Emergency
🟡 Call the rooms (02) 7906 8312 — Monday to Friday, 9am–5pm: • Spreading redness around the wound that is getting worse • Fever above 38°C without severe systemic symptoms • Yellow or green discharge from the wound • Pain that is worsening after day 3 rather than improving • The wound edges separating slightly • Any wound concern that is not an emergency but that you are unsure about If calling outside office hours, attend your GP or nearest after-hours medical clinic for wound review. |
🔴 Go to the emergency department or call 000 for: • The wound opening significantly with visible tissue beneath the skin • Heavy bleeding from the wound that does not stop with firm pressure applied for 10 minutes • Rapidly spreading redness with fever, rigors, rapid heart rate or confusion — signs of systemic infection (sepsis) • Severe worsening pain at the wound — particularly with fever and feeling very unwell • Red streaks spreading from the wound along the skin surface — may indicate spreading infection |
Risk Factors for Wound Infection
Some patients are at higher risk of developing a wound infection after surgery. Being aware of personal risk factors means being more vigilant about monitoring the wound. Risk factors include:
- Obesity — impairs wound healing and increases surgical complexity
- Diabetes — particularly if blood glucose is poorly controlled around the time of surgery
- Smoking — impairs blood flow and collagen synthesis essential for wound healing
- Immunosuppression — steroid medication, chemotherapy, or immune-modifying drugs
- Malnutrition or low protein levels
- Previous wound infection at the same site
- Emergency surgery — higher contamination risk than elective procedures
- Longer operative time — increases infection exposure
If you have risk factors: Be more vigilant about checking your wound daily, checking your temperature if you feel unwell, and contacting the rooms early if you notice any of the signs described above. Early treatment of wound infection is straightforward — delayed treatment allows infection to progress and become harder to manage. |
What Happens if a Wound Is Infected?
Wound infections are treated based on their severity. The most common treatments include:
- Antibiotics: For mild to moderate wound infections — a course of oral antibiotics directed at the likely causative bacteria. A wound swab may be taken to identify the specific organism and guide antibiotic selection.
- Wound opening and drainage: If a collection of pus has formed under the wound, the wound may need to be partially opened to allow drainage. This is a minor procedure performed under local anaesthesia.
- Wound dressing changes: An open or draining wound is managed with regular dressing changes — initially at the rooms or with a community nurse, then at home once the wound is progressing satisfactorily.
- Wound vacuum therapy: For larger or complex infected wounds, a negative pressure wound therapy device may be applied to assist healing.
- Hospital admission: Severe wound infections — particularly those with signs of systemic infection or in high-risk patients — may require IV antibiotics and hospital management.
Do not ignore a wound infection: A wound infection that is not treated will not resolve on its own — it will worsen. Early treatment with antibiotics or minor wound drainage is straightforward. Delayed treatment risks deeper infection, wound breakdown, and in rare cases, serious systemic infection. Contact the rooms early. |
Frequently Asked Questions
How soon after surgery can a wound get infected?
Wound infection signs most commonly appear between days 3 and 10 after surgery — when the initial post-operative swelling and redness have settled enough that new or worsening signs are more apparent. However, infection can develop as early as day 2 or as late as several weeks after surgery in some cases. Any new or worsening wound signs at any point in the first 4 weeks warrant assessment.
My wound smells a little — is that normal?
A very faint smell from the wound in the first day or two — from the adhesive dressing material or dried blood — can be normal. A distinctly foul or unpleasant smell from the wound, particularly if accompanied by discharge, is not normal and should be assessed by contacting the rooms or seeing your GP.
Can I treat a wound infection at home?
Do not attempt to treat a wound infection at home without medical assessment. Do not apply antiseptic solutions such as Betadine or Dettol to the wound — these delay healing and are not an appropriate treatment for infection. Do not take leftover antibiotics from a previous illness — the correct antibiotic depends on the type of infection and the bacteria involved. Contact the rooms or your GP for assessment and appropriate treatment.
Is it safe to wait until my post-operative appointment if I think my wound is infected?
No — if you suspect a wound infection, do not wait until your scheduled post-operative appointment. Contact the rooms as soon as you notice concerning signs. If the appointment is more than a day or two away and the wound signs are present, seek assessment sooner — from the rooms, your GP, or an after-hours clinic. Early treatment is straightforward; delayed treatment is not.
Specialist General Surgeon | Upper GI and Bariatric Surgery 4 Hyde Parade, Campbelltown NSW 2560 | Phone: (02) 7906 8312 [email protected] | drdeveshkaushal.com.au Office Hours: Monday – Friday, 9:00 AM – 5:00 PM Current hospital appointments and accreditations include: Sydney Southwest Private Hospital Liverpool | Campbelltown Public Hospital | Campbelltown Private Hospital | The George Hospital Medicare rebates and private health insurance benefits may apply depending on the service, referral and individual policy. Please contact the rooms and your insurer regarding fees and potential out-of-pocket costs. |
General information only: This article provides general patient education. If you are concerned about your wound, contact the rooms on (02) 7906 8312. Attend an emergency department or call 000 for severe symptoms.
Read about more Wound Care After Surgery: What to Expect in the First 5 Days |