This is self evidently infection in or around the wound after surgical intervention.
With better surgical technique, prophylactic antibiotics and newer
suture materials, the incidence wound infection has fallen from around
10% twenty years ago to less than 5% of all operations.
1. Pre-operative factors
There may be pre-existing infection, for example, from perforated
appendix or a broken bone which perforates the skin. The patient may be
a latent carrier of bacteria in the nose.
2. Operative factors
There may be lapses in the theatre technique with failure of adequate
sterilisation of instruments, the surgeon’s hands or dressings but it
is much more likely that wound infection will occur because of the type
of surgery with bacterial contamination occurring when the bowel or
bladder are opened.
3. Post-operative factors
These are introduced after the patient is returned to the ward and
with thorough attention to hand washing this has almost been eradicated.
Signs and Symptoms
The infection is usually evident 48 hours or 72 hours after the
operation but can be delayed for up to 2 weeks. There is pain in the
wound with swelling and redness around it. The patient has a
temperature and may feel generally unwell.
Modern surgical, anaesthetic, theatre and ward nursing practices are
all geared towards preventing infection and in several incidences
prophylactic antibiotics are given thus where any foreign bodies are to
be implants, for eg. a heart valve, new joint or mesh for hernia repair,
antibiotics are given at the time of operation and often for 1-2 days
Patients also have prophylactic antibiotics when the risk of
contamination is high, for example during bowel surgery and where the
wound itself is contaminated at the time of the surgery, for example
When infection has become established and an abscess is related to
the wound, this has to be formally drained and antibiotics are only
given in this instance if there is a spreading infection around the
With modern powerful antibiotics there is usually complete resolution
of the infection. An overwhelming infection with fatal consequences
usually only happens when there is a large untreated collection of
infection in either the chest or abdominal cavity.