How do I know if the wound on my abdomen is infected?

Written by WISH Clinic

Clinically reviewed by Dr. Traci A. Kimball, MD, MBA

Last medical review

Contact your surgeon for more redness or pain, swelling or bleeding, a wound that is larger, deeper, dried out or dark, or drainage that increases, thickens, turns tan, green or yellow, or smells bad. The fever number depends on whether your incision was closed or left open.

An abdominal wound is usually a surgical incision, and there is a fork in the road before you get to the signs. The advice for an incision that was closed is different from the advice for one that has been left open, and the lists of when to call are not identical. Which one describes your wound decides which list you should use.

For a closed incision, contact your surgeon if there are any of these changes around the incision: more redness or pain, swelling or bleeding, the wound is larger or deeper, or the wound looks dried out or dark. Also contact your surgeon if the drainage coming from or around the incision increases or becomes thick, tan, green, or yellow, or smells bad (pus), and if your temperature is above 100°F (37.7°C) for more than 4 hours.

For a wound being allowed to heal open, contact your provider if there is more redness, pain, swelling, or bleeding at the wound site; if the wound is larger or deeper, or it looks dried out or dark; if the drainage increases or becomes thick, tan, green, or yellow, or smells bad (which indicates pus); or if your temperature is 100.5°F (38°C) or higher.

Put those two temperature lines side by side and the difference is plain: above 100°F for more than 4 hours for a closed incision, 100.5°F or higher for an open wound. Don’t pick one or average them. If you don’t know which kind of wound you have, settle that with the person who did the surgery, because it changes the number you are watching for.

Two practical points for an abdominal incision, both for closed incisions. On clothing: do not wear tight clothing that rubs against the incision while it is healing. On washing: showers are better than baths because the wound doesn’t soak in the water. Soaking the wound could cause it to reopen or become infected.

On what to put on it, the rule is strict. Do not apply antibiotic cream or other products unless your surgeon tells you to, and do not use lotions, powders, cosmetics, or any other skin care products on the wound. An infection is not something to treat yourself with what is in the cupboard.

What to watch for

For a closed surgical incision, contact your surgeon for more redness or pain; swelling or bleeding; a wound that is larger or deeper; or a wound that looks dried out or dark. Also call if drainage increases or becomes thick, tan, green, or yellow, or smells bad (pus), or if your temperature is above 100°F (37.7°C) for more than 4 hours.

For a surgical wound being allowed to heal open, there is a separate list. Contact your provider if there is more redness, pain, swelling, or bleeding at the wound site; if the wound is larger or deeper, or it looks dried out or dark; if drainage increases or becomes thick, tan, green, or yellow, or smells bad (which indicates pus); or if your temperature is 100.5°F (38°C) or higher. The two lists are kept separate on purpose: the temperature thresholds are not the same, and which one applies depends on your wound.

Settle which of those two describes your incision before you need the number, not after. And if part of the incision has separated, say so when you call. The open-wound advice above is written for exactly that situation.

What we look at

  • Whether the incision is closed or being allowed to heal open
  • Which signs are present, and when each appeared
  • Drainage volume, colour and odor compared with the previous days
  • Whether any part of the incision has separated
  • Temperature, and how long it has been raised

Related questions

Sources

  1. MedlinePlus — Surgical wound care, closed: https://medlineplus.gov/ency/patientinstructions/000738.htm
  2. MedlinePlus — Surgical wound care, open: https://medlineplus.gov/ency/patientinstructions/000040.htm
Non-healing wound care at The WISH Clinic

The Wish Clinic®

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