Why infection matters

Any break in the skin lets germs in. Most of the time, the body fights them off and the wound heals. But when germs grow faster than the body can clear them, the wound becomes infected. An infected wound heals more slowly and can spread to the skin around it, to the bone, or into the blood.

Some people have a higher chance of infection. This includes older adults, people with diabetes, people with poor blood flow to the legs or feet, people who smoke, and anyone whose immune system is weak from illness or medicine. If you or the person you care for is in one of these groups, daily checks are even more important.

What normal healing looks like

It helps to know what is expected so you can spot what is not. In the first few days, a wound may be a little pink, slightly swollen and a bit sore. A small amount of clear or pale yellow fluid on the dressing can be normal. Over time, these signs should get better, not worse.

Healthy healing tissue in an open wound often looks moist and red or pink. Your clinician can tell you what your wound should look like at each stage.

Warning signs of infection

Call your doctor or wound care team the same day if you notice any of these:

  • Redness that spreads out from the wound or gets darker. On darker skin, redness can be hard to see, so look for skin that looks purple, darker or shiny, or feels warm or hard.
  • Swelling, warmth or pain that is getting worse instead of better.
  • Thick, cloudy, yellow, green or bloody drainage, or more drainage than usual.
  • A bad smell from the wound, even after it is cleaned.
  • A wound that stops getting smaller or starts to open up.
  • Fever or chills.
  • New red streaks on the skin leading away from the wound.

Extra care for people with diabetes

Diabetes can damage the nerves in the feet, so a person may not feel pain even when a wound is badly infected. Do not wait for pain to tell you something is wrong. Look at the wound and the skin around it every day.

High blood sugar can also be a sign of infection. If blood sugar readings are higher than normal for no clear reason, tell your doctor. Any foot wound in a person with diabetes should be checked by a clinician promptly.

When to call 911

An infection can spread into the blood and cause sepsis, a life-threatening emergency. Call 911 or go to the nearest emergency room right away if a person with a wound has any of these:

  • Confusion, extreme sleepiness, or is hard to wake up.
  • Trouble breathing or very fast breathing.
  • A racing heartbeat, or feeling faint or dizzy.
  • High fever, or shaking chills, or skin that feels cold and clammy.
  • Severe pain or a feeling of being very unwell.
  • Skin around the wound that turns black or gray, or redness that spreads quickly over a few hours.

What you can do to lower the risk

  • Wash your hands with soap and water before and after touching the wound or dressing.
  • Follow the dressing orders from your own clinician. Do not switch products or skip changes without asking.
  • Keep the dressing clean and dry, and change it if it gets wet or dirty, as your care plan allows.
  • Keep blood sugar in the range your doctor set, eat well and drink enough fluids unless you’ve been told to limit them.
  • Take antibiotics exactly as prescribed, and finish them unless your doctor tells you to stop.
  • Write down what you see each day so you can share changes with your care team.

This guide is general education, not medical advice. Follow the care plan from your own clinician. For a medical emergency, call 911.