Preventing surgical wound infections

Most surgical wounds heal quickly without problems, but some may develop infection. Surgical wound infections occur when microorganisms such as bacteria enter the incision made in the skin during an operation. Surgical wounds are vulnerable to infection from the skin or the environment during or soon after surgery.

A surgical wound infection may develop anytime from about 2–3 days after surgery until the wound has fully healed, which usually takes 2–3 weeks. In some cases where metalwork was implanted, an infection can sometimes occur several months after the operation.

• Redness, swelling and heat around the wound
• Wound becoming more painful to touch
• Fluid or yellow pus coming from the wound, which may have unpleasant smell
• Edges of any part of the wound have separated
• A raised temperature (fever)

If left untreated, the infection can spread deeper into the body or enter the bloodstream, causing symptoms such as fever and feeling very unwell. You should seek medical advice immediately if you suspect a wound infection.

Before your operation

• If you have an infection before your operation, even if it is only a cold or sore throat, inform the hospital immediately.
• You should wash your hair and take a bath or shower as usual at home before coming in for surgery or if already in hospital, the morning of your operation.
• Do not shave or remove hair from the surgical site before coming to the hospital, as this can damage the skin and increase the risk of infection.
• Keep warm before and after surgery, as it supports wound healing. Hospital environment can be cold so please bring extra clothing like a dressing gown and inform staff if you feel cold at any time.
• You should eat a healthy balanced diet before and after surgery as this is important for wound healing.

After your operation

• If you are given antibiotics, make sure that you take the whole course as instructed.
• If any staff come to look at or change your wound dressing, it is crucial that they wash their hands before and after touching it. Please ask them if you have not seen them wash their hands.
• Do not touch your wound or dressing unless advised by a healthcare professional. You should wash your hands first.
• Tell your nurse or doctor if you think your wound is becoming more painful, red or hot, also if you notice it oozing or if you start to feel unwell.
• Inform the ward staff of any issues that you notice with regards to environmental cleanliness.

• Patients undergoing surgery may be screened for MRSA before their operation depending on risk factors and the type of surgery/surgical specialty.
• Patients found to have MRSA will be asked to have a course of suppression therapy before the operation. The staff will guide patients on how to do this.
• Our operating theatres and equipment are decontaminated to the highest standards.
• Before an operation starts, the skin area is disinfected and sterile sheets are used to protect the operating area.
• The air and environment in the operating area are regularly checked for any risk of infection to patients.
• Where necessary, patients are given antibiotics before, during or after surgery to prevent infection.
• Every patient is nursed with care to try and avoid infection getting into the wound or any other area, such as a catheter or drain (where a tube is used to drain a wound of excess fluid).
• All staff should wash their hands or use the alcohol gel before they touch a dressing or wound.
• You will be given warming blankets if necessary to keep you warm.
• We have a dedicated Surgical Site Infection (SSI) Surveillance team who monitor infection rates in our patients. A member of the SSI team may visit you during your hospital stay or send you a questionnaire after discharge either via post or MyCare to monitor progress of your wound.
• If an infection is suspected, we will collect a sample from your wound using a swab and send it to the laboratory for testing. This helps identify any bacteria that may be causing the infection so we can provide the most suitable treatment.

• Please check with the ward staff before they visit to confirm visiting times and how many people are allowed to visit at the same time.
• If your visitors have signs of infection such as flu-like symptoms diarrhoea/vomiting or rash that might be infectious, they should not visit until they have fully recovered.
• Every visitor should wash their hands or use the alcohol gel before and after visiting.

If necessary, we will give you information on how to continue to look after your wound until it heals.

If you have any cause for concern, you should contact your GP.

National Institute for Health and Care Excellence (NICE)

NHS website

UK Health Security Agency (UKHSA)