How to Prevent Infection After Surgery

By understanding the common types of infections that can occur after surgery and implementing effective prevention strategies, patients can enhance their recovery journey and achieve better outcomes. Being informed and taking proactive steps can significantly reduce the risk of infection. In this blog, we speak to Rebecca Lewis, system director of infection prevention, to learn more. 

“Surgery can be a critical step on the path to recovery and improved health,” Lewis says. “But it also comes with its own set of risks, including the possibility of post-surgical infections. These infections can complicate the healing process, prolong recovery times and, in severe cases, lead to further health issues.”

Why surgical site infections are common

What to know: Surgical site infections occur in about two to four percent of all inpatient surgical procedures. They are the most common health care-associated infection in surgical patients due to a combination of patient vulnerabilities, surgical complications, bacterial contamination and hospital environments.

Patient factors can increase the risk because people with multiple health conditions or compromised immune systems are less capable of fighting off infections.

• Examples include people with diabetes, obesity, cancer or HIV.
• Older patients may have a higher risk of infection due to slower healing processes and potential underlying health issues.
• People who smoke are at a higher risk because smoking reduces blood flow, delays healing and impairs the immune response.

Surgical factors, including the type and duration of surgery, can influence infection risk. 

• Longer surgeries increase the exposure time to potential contaminants.
• Gastrointestinal tract surgeries and emergency procedures carry higher infection rates.
• Inadequate surgical techniques, such as improper handling of tissues or failure to maintain a sterile environment, can increase the risk of infection.
• Devices used during surgery (catheters or drains) can introduce bacteria into the body if not properly managed.

Bacterial contamination at the incision site is the primary culprit of post-surgical infections.

• Bacteria naturally present on the patient's skin can also enter the body through the incisions if the skin isn’t properly disinfected before surgery.
• If surgical instruments and equipment aren’t properly sterilized, they can introduce bacteria into the surgical site.
• Any breach in cleanliness in the operating room, such as unclean surfaces or airborne particles, can lead to contamination.
• Inadequate hand hygiene or improper use of gloves and gowns by the surgical team can introduce bacteria.

Hospital environments can be a source of infection due to the presence of antibiotic-resistant bacteria and other pathogens.

• The longer patients stay in a hospital setting, the more at risk they are to infections.

Post-operative care, such as improper wound cleaning or dressing, can lead to infections.

• Failing to keep the surgical site clean and properly dressed can allow bacteria to enter and cause infections.
• If drains are not managed correctly, they can become a source of infection.
• Failing to educate patients on how to care for wounds or recognize signs of infection can also inadvertently heighten the risk of infection.

What the health care team does to prevent an infection

The health care team takes surgical safety seriously and an all-hands-on-deck approach includes patient, staff and environmental cleanliness, collaboration between care providers both within the operating room and beyond, and identification of best practices to optimize your surgical recovery.     

Signs of infection after surgery

At a glance: After surgery, it's important to monitor for signs of infection. If you notice any of these symptoms, contact a health care provider urgently for evaluation and treatment. If left untreated, some severe infections can spread to your bloodstream and result in sepsis.

Symptoms of an infection after surgery may include:

• Redness and swelling around the incision
• Increased pain or tenderness at the surgical site
• Warmth at the incision
• Pus or discharge from the incision
• Fever
• Delayed wound healing
• Foul odor coming from the wound
• Hardening of the tissue around the incision
• Lymph node swelling
• Fatigue

What infections can happen after surgery?

The lowdown: After surgery, several types of infections can occur. The infections can either be directly tied to the incision at the surgical site (surgical site infections) or unrelated to the incision such as respiratory infections or urinary tract infections.

Surgical site infections

Surgical site infections (SSIs) occur after surgery in the part of the body where the surgery took place. 

• There are three types of surgical site infections that occur and they’re classified based on how severe the infection is.

Superficial incisional infections affect the outer layers of the skin and subcutaneous tissue around the surgical incision. 

• Symptoms include redness, warmth, swelling and pus or other drainage.
• These infections are usually less severe and can often be treated with antibiotics and wound care in an outpatient setting.

Deep incisional infections involve deeper layers of tissue, such as muscles and fascia. 

• Symptoms include increased pain, fever and swelling.
• These infections may require more intensive treatment, including surgical intervention to drain abscesses or remove infected tissue.

Organ/space infections occur in any organ or space that was involved in the surgery, excluding the incision itself. 

• They can lead to abscess formation and symptoms such as fever and general discomfort.
• Treatment often involves antibiotics and sometimes additional surgery to address the infection.

Other surgical infections

Some infections occur as a result of the procedure, often due to complications or due to the body's weakened state.

• Post-operative pneumonia is a lung infection that can develop after surgeries, especially procedures in the chest or abdomen. This risk is lessened with early ambulation and proper use of incentive spirometer (device to support deep breathing after inactivity or anesthesia).
• Bloodstream infections (sepsis) occur when bacteria causes a severe, widespread inflammatory response that can cause tissue damage and organ failure.
• Catheter-related infections occur at the site where a catheter is inserted, such as IV lines or urinary catheters.
• Gastrointestinal infections can occur when bacteria or other pathogens invade the digestive tract, leading to inflammation and other complications. 

Tips to lower infection risk

The bottom line: Despite being largely preventable, surgical site infections remain a challenge. Preventing infection after surgery involves a combination of health care practices and patient measures at home.

Following post-operative care instructions is crucial.

• Adhering to care instructions helps ensure that your body heals properly and efficiently.
• Understanding and following care instructions empowers you to take an active role in your recovery.

Keep up with wound care as directed.

• Regularly clean the area as advised and keep it dry to prevent bacterial growth.
• Avoid taking care of pets before touching your wound or dressings. Perform hand hygiene after any pet care.
• Be vigilant for any signs of infection and report them to your health care provider promptly.

Follow medication guidelines and don’t skip doses.

• Antibiotics help eliminate bacteria that could cause infections at the surgical site.
• Taking antibiotics as prescribed helps prevent the development of antibiotic-resistant bacteria, which can occur if medications aren’t taken correctly.

Wash your hands before touching the surgical site.

• Minimize contact with the incision to reduce the risk of introducing bacteria.

Maintain a healthy lifestyle by eating healthy and staying hydrated.

• Foods rich in vitamins, minerals and protein support the immune system and promote healing.
• Water helps your body recover and maintain overall health.

Avoid smoking and drinking alcohol.

• These can impair healing and increase the risk of infection.

Attend follow-up appointments with your physician.

• Regular check-ups can help catch any potential issues early.

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