Post-Reconstruction Surgery Fever: When to Worry and What to Do

Fever ≥100.4°F (38°C) after reconstructive surgery warrants evaluation. 100.7°F is low-grade but significant post-op.

Common Causes

• Atelectasis (most common <48h): Low-grade, resolves with incentive spirometry, ambulation.
• Infection: Surgical site (cellulitis, abscess), UTI (catheter), pneumonia, IV line sepsis.
• Drug fever: Antibiotics, heparin, others.
• Transfusion reaction.
• DVT/PE.

Assessment

• Vitals trend, surgical site inspection.
• Labs: CBC, CRP, PCT, blood cultures, urinalysis, CXR.
• Imaging if indicated (CT, US).

Action

1. Notify surgical team immediately.
2. Do NOT self-medicate with antipyretics without approval (may mask sepsis).
3. Incentive spirometry, early mobilization if cleared.
4. IV antibiotics if infection suspected.

Red Flags

• Fever >101.5°F, rigors
• Worsening pain, spreading erythema, purulent drainage
• Hemodynamic instability
• Altered mental status

Post-op fever is never "normal"—always investigate.