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

A hip wound is often a pressure sore, so contact your provider right away for blisters, a new open sore, foul odor, pus, redness and tenderness, warm or swollen skin near it, or fever. If it’s a surgical incision, a different list applies.

Hips are one of the places pressure sores form. Pressure sores tend to form where skin covers bony areas with less tissue under the skin to pad the area. These include the buttocks, elbows, hips, heels, ankles, shoulders, back and back of the head.

If that is what this is, contact your provider right away if you develop blisters, an open sore, or 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.

What makes a hip wound different is when it takes weight. It takes weight when you lie on your side — at night and during rest, when nobody is watching. Change positions often. If you are in a wheelchair, try to change your position every 15 minutes. If you are in bed, you should move or be moved about every 2 hours. A sore that gets worse overnight and settles during the day is telling you something about position, not about dressings.

A hip wound may not be a pressure sore at all. If it is a surgical incision, different signs apply. For a closed incision, contact your surgeon for more redness or pain, swelling or bleeding, a wound that is larger, deeper, dried out or dark, drainage that increases or becomes thick, tan, green or yellow or smells bad, or a temperature above 100°F (37.7°C) for more than 4 hours. It’s worth knowing which of the two describes your wound before you use either list.

Two more things about pressure sores. The skin around the wound has its own early sign: a stage I sore is a reddened, painful area on the skin that does not turn white (blanch) when pressed. And one rule people get wrong with the best intentions: do not massage the skin near or on the ulcer. This can cause more damage.

What to watch for

Contact your provider right away if you develop blisters, an open sore, or 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. If your pressure sore changes or a new one forms, tell your provider.

Tie the check to position. Look at the hip after a long spell of lying on that side, not only after sitting up, and check the other hip at the same time — if one side has been favored, the second sore is already on its way. Note whether the redness fades when the pressure comes off. Redness that does not fade is the stage I sign, and it is worth reporting before anything opens.

What we look at

  • Whether this is a pressure sore or a surgical wound
  • Which infection signs are present, and when each appeared
  • Repositioning in bed, and whether side-lying is being alternated
  • Whether redness around the sore blanches when pressed
  • Whether a second sore is forming on the opposite hip

Sources

  1. MedlinePlus — How to care for pressure sores: https://medlineplus.gov/ency/patientinstructions/000740.htm
  2. MedlinePlus — Surgical wound care, closed: https://medlineplus.gov/ency/patientinstructions/000738.htm