From the Guidelines
A surgical fever is typically defined as a body temperature of 38.5°C or higher, occurring after a surgical procedure, and its management depends on the timing and severity of the fever, as well as the presence of other symptoms such as tachycardia or wound infection 1. When considering the diagnosis and management of surgical fevers, it is essential to take into account the timing of the fever in relation to the surgical procedure.
- Early surgical fevers, occurring within the first 48 hours, are often due to non-infectious causes, and observation, dressing changes, or opening the incision site may be sufficient for patients with a temperature < 38.5°C and without tachycardia 1.
- In contrast, fevers occurring after 48 hours may indicate surgical site infections, and careful inspection of the wound is indicated, with antibiotics and opening of the suture line considered for patients with a temperature ≥ 38.5°C or a heart rate ≥ 110 beats/min 1. The management of surgical fevers also involves identifying the cause through physical examination and appropriate tests, providing supportive care with antipyretics, ensuring adequate hydration, and administering targeted antibiotics if infection is confirmed 1. It is crucial to note that the definition and management of surgical fevers may vary depending on the specific context and patient population, and the most recent and highest-quality evidence should be consulted to guide clinical decision-making 1.
- The algorithm for the management and treatment of surgical site infections, as outlined in the 2014 update by the Infectious Diseases Society of America, provides a useful framework for guiding clinical decision-making in this area 1.
From the Research
Definition of Surgical Fever
- Surgical fever is not explicitly defined in the provided studies, but it can be inferred that it refers to a fever that occurs after surgery, often as a result of infection or other complications 2.
- Fever is a regulated elevation in the setpoint temperature for all thermoregulatory responses, and it can be caused by infectious or non-infectious etiologies 2.
Causes of Surgical Fever
- Surgical site infections are a common cause of fever after surgery, and they can be caused by bacteria from the patient's endogenous flora being inoculated into the surgical site at the time of surgery 3.
- Other causes of fever after surgery can include non-infectious etiologies, such as inflammation or reaction to anesthesia 2.
Prevention and Treatment of Surgical Fever
- Strategies to prevent surgical site infections, such as avoiding razors for hair removal, maintaining normothermia, and using appropriate antibiotic prophylaxis, can also help to prevent surgical fever 3.
- Treatment of surgical fever typically focuses on addressing the underlying cause, such as treating a surgical site infection with antibiotics 3, 4, 5, 6.
Temperature Thresholds
- Maintaining normothermia, or a body temperature warmer than 36 °C, is recommended to reduce the risk of surgical site infections and fever 3.