Infection After Foot and Ankle Surgery:

What You Need to Know

While most foot and ankle surgeries heal without complication, a surgical site infection (SSI) is a possibility that every patient should understand.

Early detection is the most important factor in a successful recovery. This guide explains the warning signs, how we prevent infections, and the newest treatment options available today.

It is normal for a surgical site to be slightly red, swollen, and tender during the first week. However, an infection is different from normal healing.

Warning Signs to Watch For:

• Spreading Redness: Redness that gets larger or "streaks" away from the incision.

• Increased Pain: Pain that gets worse after the first few days, rather than better.

• New Drainage: Thick, yellow, green, or foul-smelling fluid coming from the wound.

• Fever or Chills: A temperature over 101°F (38.3°C) or feeling generally unwell (flu-like symptoms).

• Heat: The area feels hot to the touch compared to the other foot.

• Wound Opening: The edges of the incision begin to pull apart.

If you notice any of these signs, please contact our office immediately

Is My Incision Normal or Infected?

Targeted Antibiotic Use

Newer studies show that for most elective foot surgeries, a single dose of antibiotics right before surgery is the most effective approach. Research actually suggests that taking "just-in-case" oral antibiotics for several days after surgery often doesn't reduce infection risk and can lead to antibiotic resistance.
Source: SAGE Journals – Postoperative Antibiotics Study

Advanced Wound Technology

For patients at higher risk (such as those with diabetes or undergoing complex ankle replacements), we may use Closed-Incision Negative Pressure Therapy (ciNPT). This is a specialized "vacuum" dressing that helps the skin heal and has been shown in recent systematic reviews to significantly lower infection rates in complex cases.
Source: MDPI – Infection Prevention in Ankle Surgery

Patient Optimization

We work with you before surgery to optimize your health. Research confirms that managing blood sugar, improving nutrition, and stopping nicotine use are the most powerful ways you can personally lower your risk.

Treatment Options: What Happens if an Infection Occurs?

If an infection is caught early, it is often very manageable. Depending on the depth of the infection, treatments may include:

1. Oral Antibiotics: For superficial skin infections, a targeted course of antibiotics is often all that is needed.

2. Wound Care: Specialized dressings or "washouts" in the office to ensure the skin heals cleanly.

3. Surgical Cleaning (Debridement): For deeper infections, we may perform a procedure to "wash out" the area and remove any bacteria.

4. Hardware Management: If you have plates or screws, we use the latest research to decide whether to keep the hardware in place while the bone heals or remove it once the infection is cleared.

Frequently Asked Questions (FAQ) Post Operative Infections

How common is infection after foot surgery?
Infections are relatively rare, occurring in roughly 1% to 5% of cases depending on the complexity of the procedure and the patient's health.

Can I prevent an infection myself?
Yes. The best things you can do are: follow your dressing change instructions exactly, keep your foot elevated to reduce swelling (which helps the skin heal), and do not smoke or vape during your recovery.

Does a red incision always mean infection?
No. Some redness is a normal part of the inflammatory healing process. However, if the redness is spreading or accompanied by a fever, it needs to be evaluated.

Will I need to have my hardware removed if it gets infected?
Not necessarily. Many infections can be treated with antibiotics and a surgical cleaning while leaving the hardware in place, especially if the bone is still in the process of healing.