Osteomyelitis After Surgery

After orthopaedic surgery, bacteria can affect the incision, deeper soft tissue, bone, or implanted material. Ongoing inflammation does not always mean infection, but increasing pain, warmth, swelling, drainage, wound separation, fever, or reduced movement should be reported. Infection around hardware can be especially complex because the team must consider both the implant and bone stability.

Evaluation may include a wound and limb examination, blood tests, imaging, and a sample from deep tissue or fluid. A surface swab alone may not identify the organism causing a deeper infection, so the clinician chooses tests according to the wound and operation.

Call the surgical team when the wound is becoming more painful, red, swollen, or wet, or when recovery is going backward. Keep the area protected as instructed, record fever or drainage changes, and take prescribed medicines exactly as directed. Avoid self-starting leftover antibiotics because this can complicate later sampling. Management may include antimicrobial treatment, drainage, removal of infected tissue, and a decision about retaining or replacing hardware.

Get urgent care for rapidly worsening swelling, severe pain, spreading redness, heavy drainage, high fever, shaking chills, confusion, fainting, or a limb that becomes cold, pale, numb, or weak. If you have a wound with new drainage or the edges are opening, contact the surgical service promptly even without fever.

Ask whether the concern is superficial or deep, whether bone or hardware may be involved, which tests are planned, and how treatment could affect movement and weight-bearing. Ask how dressings should be changed and who to contact outside clinic hours.