Staph After Surgery: Signs of a Wound Infection

What a surgical wound infection is

A surgical site infection is an infection in the part of the body where you had surgery. It can involve the skin, the tissue underneath, organs, or implanted material such as a new hip joint.¹

Most surgical wound infections show up within the first 30 days after surgery.² That makes the first few weeks at home the time to watch your incision closely, even if you feel well.

Where staph fits in

Staphylococcus aureus, or staph, is one of the most common causes. In U.S. hospital data from 2018–2021, staph was the most often reported germ in adult infections after several kinds of surgery, including about a third of infections after bone and joint surgery and a quarter after heart surgery.³

Much of that staph comes from the patient. About 30% of people carry staph on their skin or in their nose without any problem.⁴ The World Health Organization notes that carrying staph in the nose is a risk factor for infection, and that many hospital staph infections come from the patient’s own bacteria.⁵

For that reason, some hospitals test the noses of patients having heart or bone and joint surgery. People who carry staph may be given a medicated nose ointment and an antiseptic body wash for a few days beforehand.⁵ If you have surgery coming up, ask your team whether this applies to you. You can read more in Staph in Your Nose.

Signs of a wound infection

Look at your incision every day in good light. Call your surgeon if you notice any of these:

• Redness or pain around the incision that is growing¹
• Cloudy fluid or pus draining from the wound¹
• A bad smell from the wound²
• Skin around the wound that feels hot²
• Fever or chills, or just feeling sick²

It can help to take a photo of the incision each day in the same light. Comparing pictures makes it easier to see whether redness is growing, and you can share them with your surgeon’s office if they ask.

You can’t tell by looking whether staph or another germ is to blame. Your surgeon may take a sample of the drainage for testing to find out.²

Who is more likely to get one

Anyone can get a wound infection, but some things raise the odds:²

• Diabetes that is not well controlled
• A weakened immune system
• Being overweight or having obesity
• Smoking
• Taking corticosteroid medicines
• A surgery that lasts more than 2 hours

If you have diabetes, our guide to staph and diabetes explains why healing can take longer and what helps.

What you can do before and after surgery

Some of the most useful steps are simple, and many start before you check in.

• Tell your surgeon about all your health conditions.¹
• If you smoke, try to quit. Patients who smoke get more infections.¹
• Don’t shave near the area where you will have surgery. Small nicks give germs a way in.¹
• Ask whether your hospital screens for staph before your type of surgery.⁵
• Clean your hands before and after caring for your wound.¹
• Ask family and friends not to touch your wound or dressings.¹
• If you don’t see a healthcare worker clean their hands, it is okay to ask them to.¹
• Visitors should wash their hands before entering and leaving your room. A hand rub with at least 60% alcohol works when hands aren’t visibly dirty.⁶
• Follow your wound-care instructions exactly, and ask if anything is unclear before you go home.

Questions to ask before you go home

Leaving the hospital can feel rushed. It helps to get clear answers, in writing if you can, before you go. Consider asking:

• How should I clean my incision, and how often should I change the dressing?
• When can I shower, and does the wound need to stay dry?
• What should normal healing look like for my kind of surgery?
• Which signs mean I should call, and which mean I should go to the emergency room?
• Who do I call after hours or on weekends?

Bring a family member or friend if you can. A second set of ears helps, and they can help you keep an eye on the wound in the days ahead.

When to call your surgeon

The CDC advises calling your healthcare provider right away if you notice signs of infection.¹ Don’t wait for your next scheduled visit if you have:

• Redness and pain at the surgery site that are spreading or getting worse
• Pus, cloudy drainage or a bad smell from the wound
• A fever or chills
• Skin around the wound that feels hot

Go to urgent care or call 911 if you have a fever with fast-spreading redness, feel confused, have trouble breathing, or feel very unwell.

Don’t press on, open or drain the wound, and don’t put home remedies on it. Treatment usually includes antibiotics, and sometimes a second procedure is needed.¹ Your surgeon will decide what is right for you.