Postoperative fever

Postoperative fever refers to an elevated body temperature (≥ 38.5°C) occurring after a recent surgical procedure. Diagnosing the cause of postoperative fever can sometimes be challenging; while fever in this context may be benign, self-limited, or unrelated to the surgical procedure, it can also be indicative of a surgical complication, such as infection. Postoperative fever refers to an elevated body temperature (≥ 38.5°C) occurring after a recent surgical procedure. Diagnosing the cause of postoperative fever can sometimes be challenging; while fever in this context may be benign, self-limited, or unrelated to the surgical procedure, it can also be indicative of a surgical complication, such as infection. The most common causes of postoperative fever are often summarized for medical students by a mnemonic beginning with the letter W. The classic list consists of five W's – Wind, Water, Wound, Walking, and Wonder Drugs, but two other causes should also be considered – Wing/Waterway and (W)abscess. There is a characteristic timeframe after surgery when many of these complications tend to develop (postoperative days or POD). Other important causes of early post-operative fever that are omitted from this list include malignant hyperthermia, a potentially life-threatening but treatable response to inhalational anesthetic and paralytic agents. Early postoperative fever (i.e., within the first 48 hours post-operatively) has often been ascribed to atelectasis, or splinting, but it is most likely part of a natural and non-infectious inflammatory response (with sympathetic nervous system involvement) to the tissue injury sustained during surgery; it generally requires no medical intervention except antipyretics and extra fluid intake.