In short. Antibiotics kept in a drawer, squeezing a wound and covering a spreading infection all make the next assessment harder rather than better.
Key points
- There is no need to be comprehensive.
- The four facts above decide almost everything about what happens next, and they are all things you can observe.
- A patient who telephones and says that the redness has moved a finger's width past a mark made two hours ago, that the discharge has turned yellow, and that she has chills, has given a clearer account than a page of description would.
Most of what a patient can usefully do about a wound that worries her is to describe it accurately and get it seen. The rest is a short list of things not to do, and each of them makes the next assessment harder rather than better.
What to do
Mark the outer margin of any redness and write the time. Photograph the wound in good light with the mark in the frame. Keep the wound dressed as your team instructed. Contact the team and describe four things: where the redness reaches, whether that edge has moved, what the discharge looks like, and whether you have a fever or feel unwell. If the team cannot be reached, call the hospital main line.
Four sentences are enough
There is no need to be comprehensive. The four facts above decide almost everything about what happens next, and they are all things you can observe. A patient who telephones and says that the redness has moved a finger's width past a mark made two hours ago, that the discharge has turned yellow, and that she has chills, has given a clearer account than a page of description would.
What not to do
Do not take an antibiotic you have at home. It treats the wrong organism or treats it inadequately, and by partially suppressing the infection it makes a sample less likely to identify anything. Do not squeeze or press the wound, because that can spread infection into deeper tissue. Do not cover a spreading redness, because the margin is the finding. Do not remove the dressing to inspect the wound, because that removes the management that was put in place. And do not clean the wound with anything your team has not specified.
Why each of those matters
They have one thing in common: each of them destroys information that the assessment depends on, or moves infection further than it had already gone. A partially treated infection, a squeezed wound, a covered margin and a wound cleaned of its discharge all present the clinician with a less clear picture than the one that existed before. That is why the advice is to observe carefully and to leave the wound alone rather than to manage it at home.
Things not to do while you wait
- Do not take an antibiotic that was prescribed for something else, or left over from a previous course.
- Do not squeeze the wound, or cover a redness that is spreading.
- Do not wait for a call back when the redness is spreading or you have fever with chills.
A wound that is healing is best served by being left as it was dressed and being looked at on schedule. A wound that is infected is best served by being seen early and described accurately. Neither of those is improved by anything done at home.
Frequently asked questions
Can I use an antibiotic left over from before?
No. An antibiotic has to match the organism causing the infection, and one chosen at random treats the wrong cause or treats it inadequately. It also partially suppresses what is there, which makes a sample less likely to identify anything and leaves the next clinician working from a less clear picture.
Should I clean the wound more often?
Follow the instructions you were given and do not add anything to them. Cleaning more often, or with an antiseptic or alcohol, can irritate healing tissue and removes the discharge that the assessment depends on. Where the wound needs cleaning, your team will say how and with what.
Should I cover the red area?
Do not cover a spreading redness in order to keep it out of sight or to protect it. Covering hides the margin, which is the finding that decides what happens next. Keep the wound dressed as instructed, and let the skin around it be seen, or photograph it with the time recorded.
Risks & Limitations
- Redness and warmth are the first stage of healing as well as the first sign of infection. Direction and speed decide the question, so a margin that advances over hours is the finding rather than the presence of redness.
- An infection that is spreading can move quickly. Spreading redness, a red line tracking up a limb, fever with chills, and skin turning dusky or black all need emergency care rather than a review appointment.
- An antibiotic has to match the organism. A course taken from a drawer, or one that is stopped early, treats the wrong cause or treats it inadequately and makes the next assessment harder.
- An implant has no blood supply of its own, so an infection beside it behaves differently and can be present with far less to see. It is seen the same day rather than watched.
- Where an infection needs an operation, the aim is to preserve tissue that is still viable and to end the infection. It cannot restore tissue that has already been destroyed.
- No assessment predicts an infection exactly, which is why the warning findings are taught to every patient rather than only to those at higher risk.
When to Seek Care
- Redness that is spreading outward, or a red line tracking up a limb &mdash — seek emergency care now.
- Fever with chills, shivering, or feeling generally very unwell &mdash — seek emergency care now.
- Skin around the wound turning dusky, blistered or black &mdash — seek emergency care now.
- Pus, or discharge that has become thick, yellow-green or foul-smelling — contact the team the same day.
- Increasing pain, heat and swelling after the first week, or a wound that is opening.
- A red, hot, tender area around an implant or an injected area.
References & Further Reading
- American Society of Plastic Surgeons (ASPS) - patient safety guidance on surgical site infection
- National Institute for Health and Care Excellence (NICE, UK) - guidance on surgical site infection prevention and management
- Cochrane Library - systematic reviews on antibiotic prophylaxis and wound care in surgery
- British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) - patient information on wound care after surgery
- Chinese Medical Association Plastic Surgery Branch - clinical guidance
This page is patient education, not medical advice, and it does not cite individual studies. Discuss your own case with a qualified clinician. To arrange an assessment at Chongqing West District Hospital, see Contact & Consultation.