What are the warning signs of wound infection?

Warning signs differ by wound type, but most lists share redness, warmth or swelling, more drainage or pus, odor, more pain, and fever. The list that applies to you is the one for your kind of wound.

Warning signs of wound infection are not the same for every wound, because they depend on the kind of wound. Rather than flatten them into one list, here are the signs for each.

For a pressure sore, contact your provider right away if you develop blisters, an open sore, or show any signs of infection, such as a foul odor from the sore, pus coming out of the sore, redness and tenderness around the sore, skin close to the sore that is warm or swollen, or fever.

For a diabetic foot ulcer, the signs are redness, increased warmth, or swelling around the wound; extra drainage; pus; odor; fever or chills; increased pain; and increased firmness around the wound. There’s also a separate instruction: contact your provider if your foot ulcer is very white, blue, or black.

For an ischemic ulcer, the signs are redness, increased warmth, or swelling around the wound; more drainage than before or drainage that is yellowish or cloudy; bleeding; odor; fever or chills; and increased pain.

For a surgical incision, contact your surgeon if there is more redness or pain, swelling or bleeding, if the wound is larger or deeper, or if it looks dried out or dark. Also contact your surgeon if drainage increases or becomes thick, tan, green, or yellow, or smells bad.

For chronic wounds in general, the signs are increasing pain, redness spreading around the wound, swelling or warmth, pus or a change in the wound fluid, bad smell, and fever or feeling unwell.

Taken together, these lists overlap a lot: redness, warmth or swelling, more drainage or pus, odor, more pain, and fever show up in nearly all of them. But the differences are real, and the instructions that go with each list are for that wound. If you have a wound, the list to use is the one for your kind of wound, and the person treating it can tell you which that is.

What to watch for

Each wound type comes with its own instruction. For a pressure sore, contact your provider right away if you develop blisters, an open sore, or any signs of infection. For a diabetic foot ulcer and for an ischemic ulcer, contact your provider if there are signs of infection. For a surgical incision, contact your surgeon. For chronic wounds in general, seek medical advice promptly.

Fever appears in all of these lists. The temperature that counts as a fever differs depending on the wound, so no single number is given here. Ask what threshold applies to your wound.

Wound Wizard is general education and can’t assess your wound or your situation. Your own clinician is the right person to ask about your wound.

What we look at

  • Examining the wound and the skin around it
  • Identifying the type of wound, which determines what to watch for
  • Telling you which signs matter most in your case
  • Deciding whether treatment for infection is needed

Sources

  1. How to care for pressure sores — MedlinePlus, U.S. National Library of Medicine https://www.medlineplus.gov/ency/patientinstructions/000740.htm
  2. Diabetes - foot ulcers — MedlinePlus, U.S. National Library of Medicine https://medlineplus.gov/ency/patientinstructions/000077.htm
  3. Ischemic ulcers - self-care — MedlinePlus, U.S. National Library of Medicine https://medlineplus.gov/ency/patientinstructions/000742.htm
  4. Surgical wound care - closed — MedlinePlus, U.S. National Library of Medicine https://medlineplus.gov/ency/patientinstructions/000738.htm
  5. Wound Q&A for patients and relatives — European Wound Management Association https://ewma.org/resources-for-patients-private-carers/wound-qa-for-patients-and-relatives/