If your surgical incision shows signs of infection, contact your surgeon’s office or the doctor who performed your procedure as soon as possible. Most surgical site infections are treatable when caught early, but they can escalate quickly without proper care. While you wait for your appointment, avoid applying antibiotic ointments or home remedies to the wound unless your doctor has specifically told you to do so.
How to Recognize an Infected Incision
Some redness and tenderness around a fresh incision is normal healing. Infection looks different. The key warning signs include redness that spreads beyond the edges of the incision, cloudy or thick discharge (white, cream, yellow, or green), warmth or heat radiating from the wound, increasing pain rather than gradually improving pain, a noticeable odor from the incision, and fever.
One useful way to track changes is to look at the redness around the wound. Normal post-surgical redness stays close to the incision line and fades over the first few days. Infected redness expands outward, sometimes with visible streaking. If you notice the red area growing, that’s a strong signal something is wrong. An opening along the incision line that gets deeper, longer, or wider is another red flag that points to both infection and wound breakdown.
What to Do Right Away
Your first step is calling the surgeon who performed your operation. They already know the type of surgery, the location, and your risk factors, which makes them the best person to evaluate what’s happening. When you call, be ready to describe what the wound looks like, when the changes started, whether you have a fever, and whether the discharge has changed in color or amount.
Before your appointment, take a photo of the wound with your phone. Research on post-surgical monitoring has shown that photos taken at regular intervals (such as days 3, 7, and 15 after surgery) help clinicians catch infections earlier. Even if you haven’t been tracking from the start, a clear, well-lit photo gives your doctor something concrete to assess, especially if you’re calling after hours or using a telehealth visit. Place a coin or ruler next to the wound for scale if you can.
In the meantime, wash your hands thoroughly before and after touching or being near the incision. Clean the wound gently with unscented soap and water, and change your dressing if it’s soiled. Don’t squeeze the wound, try to drain it yourself, or apply hydrogen peroxide or alcohol, as these can damage healing tissue.
What Your Doctor Will Likely Do
Treatment depends on how severe the infection is. For many surgical site infections, the standard approach is opening the wound (removing some or all of the stitches or staples) and draining any fluid or pus that has collected underneath. This sounds alarming, but it’s often the single most effective step. Once the infected material is out, the wound can heal from the inside.
Antibiotics aren’t always necessary. Clinical guidelines recommend them mainly when the infection shows significant systemic signs: redness and swelling extending more than 5 centimeters from the wound edge, a fever above 101.3°F, or an elevated heart rate. For a localized infection that stays close to the incision, drainage alone is often enough.
When antibiotics are prescribed, the type depends on where your surgery was. Infections from operations on the trunk, head, neck, or limbs are typically caused by skin bacteria like staph, so your doctor will choose an antibiotic targeting those organisms. Infections following abdominal, pelvic, or gastrointestinal surgery involve a broader range of bacteria, including types that live in the gut, and require different coverage. If the infection doesn’t respond to the first round of antibiotics, your doctor may take a wound culture (a swab of the infected area) to identify exactly which bacteria are involved and which drugs will work against them.
MRSA and Resistant Infections
MRSA is a type of staph bacteria that resists many common antibiotics, and the CDC classifies it as a “serious threat.” People who have recently had surgery or have medical devices in their body are at higher risk. If your wound infection isn’t improving after a few days of treatment, or if you have a history of MRSA, your doctor will likely order a culture to check for resistant bacteria.
Even with MRSA, the primary treatment for skin infections is still drainage. Effective antibiotics exist for MRSA, but the right one needs to be matched to the specific strain through lab testing. This is why wound cultures matter so much for infections that don’t respond to initial treatment.
Caring for the Wound at Home
Once your doctor has treated the infection, you’ll likely need to care for the wound at home as it heals. This typically means cleaning it daily with gentle, unscented soap and water, then applying a fresh dressing. Your doctor will give you specific instructions on how often to change the dressing, which can range from once a day to every few days depending on the wound’s location and severity.
Hand hygiene is critical every single time you touch or go near the wound. Wash with soap and water for at least 20 seconds before and after. Keep the area dry between cleanings, and avoid submerging it in baths, pools, or hot tubs until your doctor clears you. Wear loose clothing that doesn’t rub against the incision.
Continue taking photos every few days so you can track whether the redness is shrinking and the discharge is decreasing. This visual record is helpful for follow-up visits and gives you an objective way to notice gradual changes you might miss day to day.
When the Wound Starts to Open
Infection weakens healing tissue, which means an infected incision can partially or fully separate. This is called wound dehiscence. Signs include visible gaps along the incision line, a feeling of pulling or ripping at the site, broken sutures, bleeding, and increased swelling. If the wound opens slightly at the surface, your doctor can usually manage it with wound packing and dressing changes that allow it to heal gradually from the bottom up.
The most serious complication of dehiscence is evisceration, where internal organs push through the opening. This is rare and primarily a risk with abdominal surgeries. If you ever see tissue bulging through your incision, cover the area with a clean, damp cloth and get to an emergency room immediately.
Signs That Require Emergency Care
Most surgical site infections are managed in your surgeon’s office. But infection can sometimes spread into the bloodstream, causing sepsis, which is a medical emergency. Go to the emergency room if you experience any combination of these symptoms alongside your wound changes:
- Confusion or disorientation
- Rapid breathing or shortness of breath
- Fast heart rate
- High fever or unusually low body temperature with chills
- Extreme pain or discomfort beyond what you’d expect
- Warm, clammy, or sweaty skin
- Very low urine output
A high heart rate, confusion, or rapid breathing can be early signs that the infection has moved beyond the wound. Don’t wait for multiple symptoms to appear before seeking emergency care. Even one of these, combined with a wound that looks infected, warrants an ER visit.
How Long Recovery Takes
An infected incision takes longer to heal than a clean one. A straightforward infection treated with drainage alone may add one to two weeks to your recovery. If the wound needs to be left open to heal from the inside out (called healing by secondary intention), the timeline stretches further, sometimes to several weeks or even a couple of months for larger wounds. Antibiotic courses for surgical infections typically run 7 to 14 days, though your doctor may adjust based on how the wound responds.
The infection itself usually begins improving within 48 to 72 hours of drainage and, if prescribed, antibiotics. If you don’t see any improvement in that window, contact your doctor. It may mean the bacteria are resistant to the chosen antibiotic, or that the wound needs additional drainage. Patience with the healing process matters, but so does speaking up when things aren’t trending in the right direction.