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Post-operative infections, also known as surgical site infections, are common health problems that can occur after surgical interventions and can cause serious complications. These infections can present with early symptoms such as redness, swelling, pain or purulent discharge from the incision site. Risk factors include individual characteristics such as obesity, diabetes, immune system weakness, and factors related to the surgical process, such as prolonged operations and the use of implants. Accurate recognition of these conditions and timely intervention are critical to prevent complications and improve patient outcomes.
How long after surgery can the symptoms of infection appear?
Symptoms of infection after surgery may appear at different times depending on the type of infection and the affected tissue. Superficial incisional surgical site infections (SSIs) usually occur within 5 to 7 days after surgery. Symptoms such as redness at the incision site, increased temperature, swelling and purulent discharge are common with this type of infection. Deep incisional CAE affects deeper tissues such as fascia and muscle and symptoms usually appear within 7 to 14 days. Deeper infections have more serious symptoms such as increased pain, fever and wound dehiscence.
Organ or cavity CAE develops in organs or anatomical cavities opened during surgery. These infections can occur within the first 30 days after surgery or up to one year if implants are used. Symptoms are specific to the infected organ or cavity and usually include fever and organ dysfunction.
A study in Ethiopia showed that the majority of CAE cases were detected between 9 and 16 days after surgery after hospital discharge. This emphasizes the importance of post-discharge monitoring. It has also been demonstrated that some biomarkers can be detected days before signs of infection appear. This can allow early detection of infections, leading to prompt treatment and better patient outcomes.
Which Factors Increase the Risk of Postoperative Infection?
Multiple factors can be effective in the development of postoperative infections. Patient-related factors include advanced age and a weakened immune system, with the male gender posing a higher risk for certain surgical procedures. Obesity increases the risk of infection by negatively affecting wound healing with a high body mass index. The risk is higher in diabetic patients because hyperglycemia impairs immune function and delays wound healing. Smoking is also an important factor that increases the risk of infection by weakening tissue oxygenation and the immune system. Inadequate or excessive nutrition may also increase the risk by negatively affecting the immune system.
Among the factors related to the surgical process, the duration of surgery plays an important role. Prolonged procedures increase the risk of infection by increasing tissue exposure time. Open surgical techniques are associated with higher infection rates compared to minimally invasive methods. In addition, the level of wound contamination and the presence of foreign bodies (e.g. implants) can significantly increase the risk of infection. Biofilm formation on implants can further complicate the treatment of infection.
Preoperative factors include prolonged hospitalization and pre-existing infections before surgery. Lack of compliance with aseptic rules during surgery or inadequate postoperative wound care are also important factors that increase the risk. Neglecting blood sugar management can further increase the risk of infection.
What are the Possible Complications of Postoperative Infections?
Postoperative infections not only prolong the healing process but can also lead to serious complications. Delayed wound healing results in increased inflammation and tissue damage in infected areas. This not only prolongs hospitalization but also increases healthcare costs and increases the risk of other complications.
Surgical site infections (SSIs) are one of the most common postoperative problems and are divided into three main categories: superficial incisional, deep incisional and organ/cavity infections. Superficial incisional infections affect the skin and subcutaneous tissue, while deep incisional infections affect deeper tissues such as muscle and fascia. Organ or cavity infections develop in anatomical sites that were intervened during surgery but outside the incision. Such infections may increase morbidity, require additional surgical intervention and may even lead to life-threatening conditions.
Sepsis is a serious complication that can develop as a result of systemic spread of infection. Uncontrolled immune responses can lead to septic shock and multiple organ failure. This condition carries a high risk of death and requires rapid diagnosis and treatment. In addition, postoperative infections prolong hospitalization and create additional burden for both the patient and the healthcare system. The long recovery period can also negatively affect patients psychologically and reduce their quality of life.
How can postoperative infections be prevented?
Prevention of postoperative infections is a comprehensive process that requires the active participation of both patients and healthcare professionals. First of all, wound care includes regular dressing changes in line with standard protocols, compliance with hand hygiene and ensuring sterility conditions. In this process, it is of great importance to educate healthcare professionals as well as patients about wound care and infection risks. Blood glucose control plays a critical role in reducing the risk of infection, especially in diabetic patients. Postoperative hyperglycemia negatively affects the immune system response and predisposes to the development of infection. Finally, informing patients about the signs of infection (e.g. redness, pain, swelling and inflammation) enables early recognition and treatment of complications. Effective implementation of these methods contributes to a safe and successful postoperative recovery.
When to seek medical attention in case of suspected postoperative infection?
Recognizing the signs of post-operative infection and seeking medical help at the right time is extremely important for the success of the healing process. If symptoms such as redness, swelling, pain, purulent discharge or fever above 38°C develop at the surgical site, you should immediately consult a healthcare professional. Early intervention is critical to prevent more serious complications, especially if signs of infection worsen rapidly or general health deteriorates. In such cases, healthcare professionals will perform the necessary assessments to diagnose the infection and formulate a treatment plan. In addition, although surgical site infections can usually be controlled with antibiotic treatment, in some cases additional medical interventions may be required. Early diagnosis and treatment is a vital step to prevent the spread of infection and ensure a healthier postoperative period.
Plastic Surgeon Dr. Erman Ak completed his primary and secondary education in Mersin and his high school education at Mersin Science High School. He graduated from Hacettepe University Faculty of Medicine as a Medical Doctor in 2014. He started his specialist training at Istanbul University Çapa Faculty of Medicine, Department of Plastic Reconstructive and Aesthetic Surgery in 2014. He performed many successful cleft lip and palate, congenital anomalies and jaw surgery operations at the hospital, which is one of the few jaw surgery centers in Istanbul. These difficult and tiring surgeries helped Dr. Erman Ak create his own concept in facial surgery.
