Monitoring caesarean-section surgical wounds for infection

What are surgical wound infections?

Many germs live in and on our bodies and also in our environment. Most are harmless or even useful. Our bodies have natural defenses against germs that can cause harm. Our skin normally prevents germs from entering our bodies but any break in the skin can allow them to enter and cause an infection.

Most surgical wounds heal up rapidly without any complications. A small number of surgical wounds can develop an infection. This happens when germs enter the incision (cut) that was made by the surgeon.

When do these infections develop?

A surgical wound infection can develop at any time from 2 to 3 days after surgery until the wound has healed, usually 2 to 3 weeks after the operation. Although wound infection is a recognised complication of any surgery, they are uncommon.

Most wound infections are limited to the skin but they can sometimes spread to the deeper tissues.

How will my wound be monitored?

During your stay in hospital, the nurse or midwife looking after you will check for any signs of infection. If you are concerned about your wound, tell the nurse or midwife who is looking after you.

Different types of dressing can be applied to the wound after the operation. Some dressings are removed before you are discharged home but many dressings are designed to stay in place for 5 to 7 days. This will be explained to you before you leave hospital.

Infection can develop once you are home. Some redness and swelling is expected after surgery, however, you might have an infection if you develop one or more of the following symptoms:

• the skin around your wound gets red or sore or it feels hot and swollen
• your wound has a fluid discharge, often green or yellow coloured pus
• your wound opens up
• you feel generally unwell or feverish, or you have a temperature (fever)
• your wound has a distinctive odour (smell)

What happens if I develop symptoms?

If you think you have a problem with your wound after you get home, contact your GP, community midwife or maternity triage as soon as possible. You may be referred back to Maternity Triage for review.

If you feel unwell contact Maternity Triage, the contact details are at the end of this page.

If the nurse, midwife or doctor suspects that you have a surgical wound infection, they might take a sample from the surface of your wound with a swab and send it to the laboratory for tests. You may be prescribed antibiotics to treat the infection.

Keep yourself well hydrated by drinking plenty of fluids (not alcohol) and taking pain relief medication as required.

Surgical Site Infection Surveillance

Gloucestershire Hospitals Surgical Site Infection Surveillance (SISS) team monitors surgical site infection rates, including infection rates after a caesarean section. To help with this, we collect personal information about you and your operation. We also collect information about your risk of developing a surgical wound infection, including:

• Your general health before your operation
• Information about your operation
• Information about any infections you may have had following your surgery

Around 30 to 40 days after your surgery, a member of the SSIS team will telephone you (this may be from a mobile number). This call will be regarding your wound only and no other questions will be asked. If we are unable to contact you, we will send a questionnaire in the post. Participation in the survey is purely voluntary and you are free to decline if you wish.

The responses from the questionnaires allows us to get a true picture of the number of patients who get wound infections after surgery. The information we get from patients helps us to make changes to our practice and improve our care.

Contact us

If you have a problem with your wound after you have left the hospital, please contact your GP, community midwife or maternity triage.

If you feel unwell contact Maternity Triage on 0300 422 5541 (available 24 hours).