Jul 1, 2016

Transcript

Interviewer: You just had a surgical procedure and a few days later an infection develops. Would you know what that even looks like? We'll talk about that next on The Scope.

Announcer: This is From the Front Lines with emergency room physician Dr. Troy Madsen on The Scope.

Interviewer: Dr. Troy Madsen is an emergency room physician at University of Utah Health Care, and one point we were talking about some of the things that you see and one of the things that you see fairly commonly are surgical site infection. So if somebody has had a procedure done and it's gotten infected, which can happen, and then they come into the ER to get treatment. Tell me a little bit about that.

Dr. Madsen: You're right. It is something that happens. Surgeons do everything they possibly can do to limit the infection rates with sterile procedure and all the steps that are taken during and after an operation, but infections still are not uncommon. We do see those cases in the ER of people who have had operations and have infections, and I think the biggest thing that's challenging with this is sometimes we see cases where people have really severe infections.

Interviewer: Like they waited too long?

Dr. Madsen: Exactly. And you think to yourself, "Man, if they had just come in two days ago, they could have just gotten on an antibiotic and gone home." But at this point it's become so severe that they have to be admitted to the hospital on IV antibiotics, sometimes have to go back to the operating room to open that up and try and get that infection out. So it's certainly worth knowing what to watch for.

The number one thing is fever. If you've had an infection, if you're having fevers, that's a reason to absolutely call your surgeon. They will likely tell you either see me in clinic tonight or today or tomorrow or go to the ER to get blood work done and take a look at the wound.

The other thing we'll see is drainage from the wound. It's natural to have some kind of drainage, maybe a little bleeding from the wound after an operation, but if you start to see this yellowish colored or darker colored pus coming out of there, or you're seeing this on the dressing that goes on the wound, that's a reason to again call your surgeon and/or get to the ER.

The other big thing is redness around the wound. You figure you had part of your body cut open, it's going to be kind of irritated, kind of inflamed, but when you start to see this bright red color around a wound, you touch it, it feels warm, that's another pretty serious sign that you've got an infection in your wound.

So these are probably the three biggest things that I see; drainage from the wound, redness around the wound, fever, all reasons to get in touch with your surgeon, get someone to take a look at this, and then possibly get on an antibiotic to catch this early enough so it's not something that requires hospitalization or another surgery.

Interviewer: So it sounds like time is crucially important, and it's not one of those things that you might want to go, "Well, I'm just going to wait another half day and see if it starts looking any worse."

Dr. Madsen: Exactly, and there's no harm in just having someone take a look at it. It's a time where you really do have to be careful. No harm in having someone take a look and say, "Actually, that's normal, that's what's expected after surgery," and then giving it another day or two, but you want to catch these things early.

Interviewer: Yeah. So call your surgeon. If you're not able to get a hold of them, an urgent care if they're open, would that be okay?

Dr. Madsen: Yeah, as long as you've got someone who can look at it, an urgent care or . . . they may prefer you to come to the ER, just because if it's the ER, preferably the one affiliated with the hospital where you had the surgery, because then the ER knows exactly what the procedure was. The surgeon can then access all the records from the ER. It just makes it a little easier that way to get a sense of what's going on.

Interviewer: Gotcha. So have somebody take a look at it. Take it seriously.

Dr. Madsen: Yes.

Interviewer: Especially if you just had a surgery.

Dr. Madsen: Absolutely.

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