Postoperative fever is where a Pt develops a fever after a surgery. It is a common condition, but is challenging, because it can be a hallmark of a serious underlying condition.
If postop fever occurs in the first 24 hours after a major surgery, it is most often a result of natural and non-infectious inflammatory response to tissue injury sustained in the procedure itself → requires no intervention
5 W's, including:
Wind, which occurs 1-2 days after surgery. It includes:
Lungs, i.e. pneumonia, and aspiration
Water, which occurs 3-5 days after surgery. It includes:
Related to indwelling catheter (during surgery or currently, i.e. Foley catheter)
Walking (or Veins, which sounds like "Weins", which occurs 4-6 adys after surgery. it includes:
PE (pulmonary embolism)
Wound, which occurs 5-7 days after surgery. It includes:
Surgical site infection, e.g. the uterus
Wonder drugs, which occurs 7+ days after surgery. It includes:
Infections related to IV lines or reaction to blood products
What causes fever after an operation?
We summarize it in the 5 W's. Wind. Water. Walking. Wound. Wonder drugs. Wind is pneumonia and aspiration. Water is UTI and catheters. Walking is DVT and PE. Wound is surgical site infection. Wonder drugs are fevers due to drugs, or infections due to IV lines or blood products.
Review of systems
IV antibiotics → prophylactic
Anticoagulants (e.g. clexane) → thrombotic risk
33% will develop fever after a surgery depending on the type of surgery, but only a small percentage are due to an infection