Weighing the risks: Why an infection complicates surgery
Undergoing surgery is a significant event for your body, placing it under considerable stress. When an infection is present, your immune system is already taxed, working hard to fight off the illness. Adding the stress of surgery and anesthesia can make recovery more difficult and increase the likelihood of complications. Medical professionals must perform a careful risk-benefit analysis for every patient, considering their unique health status and the urgency of the procedure.
Impact on your immune system
Your immune system is your body's defense mechanism against disease. During surgery, your immune response is naturally altered, making you more vulnerable to new infections, especially at the surgical site. A pre-existing infection can overwhelm your body's ability to heal and protect itself effectively.
Increased anesthesia complications
Anesthesia, particularly general anesthesia, can pose heightened risks when you are sick. For example, a respiratory infection can lead to breathing difficulties during and after the procedure. This is because anesthesia can irritate the airways and compound existing breathing issues. An anesthesiologist will carefully assess your condition to determine if proceeding is safe, particularly with respiratory infections or congestion.
The risk of surgical site infections
An active infection, even one seemingly minor like a skin lesion or urinary tract infection, can significantly increase the risk of a more serious surgical site infection. Bacteria can spread to the surgical wound, leading to delayed healing, complications, and a prolonged recovery. In severe cases, this can lead to sepsis, a life-threatening condition.
Elective vs. Emergency surgery with an infection
Not all surgeries are treated equally when an infection is present. The decision to proceed often hinges on whether the surgery is considered elective or an emergency.
Elective surgery
Elective procedures, such as joint replacements or cosmetic surgeries, are typically postponed until the patient is fully recovered from the infection. This delay allows the body to regain its strength and immune function, creating a safer environment for surgery and optimal healing. Medical teams will usually reschedule the procedure once the infection has cleared and any symptoms have resolved.
Emergency surgery
In emergency situations, such as a ruptured appendix, severe trauma, or a life-threatening abscess, the surgery must proceed regardless of a pre-existing infection. In these cases, the risk of delaying the procedure outweighs the risks associated with the infection. Medical teams will take additional precautions, including aggressive antibiotic therapy, to manage the infection while performing the life-saving procedure.
What to do if you get sick before a planned surgery
If you develop symptoms of an infection before a scheduled procedure, it is vital to communicate with your medical team immediately. Do not attempt to hide your symptoms, even if they seem mild.
- Inform your surgeon's office: Call your surgeon's office as soon as you notice symptoms, detailing your condition and its severity. They can provide guidance on the next steps.
- Follow your doctor's advice: Your medical team will assess the situation and determine the safest course of action. This may involve:
- Rescheduling the procedure to a later date.
- Prescribing antibiotics to clear a bacterial infection before proceeding.
- Proceeding with special precautions if the infection is minor and localized.
- Monitor symptoms carefully: Keep track of your symptoms, including fever, cough, and congestion, to report them accurately to your healthcare provider.
Comparison of risks: Surgery with vs. without infection
| Factor | Surgery with Active Infection | Surgery without Active Infection |
|---|---|---|
| Immune System | Compromised, busy fighting illness. | Strong, focused on healing from surgery. |
| Anesthesia Risks | Higher risk of complications, especially respiratory issues. | Standard risks, with a healthier patient being more resilient. |
| Surgical Site Infection | Significantly increased risk. | Standard, though low, risk with proper precautions. |
| Recovery Time | Potentially delayed healing and prolonged recovery. | Faster, smoother recovery with fewer complications. |
| Overall Safety | Generally less safe, especially for elective procedures. | Optimizes patient safety and outcomes. |
How specific infections impact surgical decisions
Different types of infections present unique challenges and considerations for surgery.
Respiratory infections
Respiratory illnesses like the flu, bronchitis, or COVID-19 significantly increase the risk of anesthesia complications and postoperative pneumonia. These surgeries are almost always postponed unless they are an emergency.
Skin infections
A localized skin infection, such as a boil or cellulitis, can pose a risk of spreading to the surgical site. The medical team will likely treat the infection with antibiotics before proceeding with elective surgery.
Urinary tract infections (UTIs)
UTIs are a common reason for postponing elective procedures, particularly those involving catheterization. Asymptomatic UTIs can be detected during pre-operative screening and are typically treated with antibiotics before the procedure.
Dental infections
In some cases, a severe dental infection or abscess can increase the risk of complications during surgery, particularly if it spreads systemically. Surgeons may request that dental issues be addressed before a major procedure. For more information on managing health, visit the CDC website.
Conclusion: Prioritizing patient safety above all
The overarching principle guiding surgical decisions when an infection is present is patient safety. While it can be disappointing to have a planned surgery delayed, the risks associated with proceeding while ill are substantial. By working closely with your medical team and allowing time for your body to fully recover, you significantly increase your chances of a successful procedure and a smooth, complication-free recovery. Always be transparent with your healthcare providers about any symptoms or illnesses you may have before surgery.
