Helping Children with Congenital Heart Conditions Stay Free and Clear from Surgical Site Infections

| Last updated on August 2, 2023

When a parent is planning for their child’s upcoming surgery, post-operative care and complications like surgical site infections aren’t often top of mind - getting through the operation is the top concern.

But, after a child is wheeled back through the operating room doors, a new set of challenges and treatment begins. 

After surgery comes post-operative care in a recovery unit such as the ICU or PACU, where children are closely monitored for pain, nausea and infection. 

Postoperative care is critical to protecting patients from complications and ensuring great outcomes.

One of the most important areas of care post-op is incision care, which is why the leading pediatric congenital heart program in the US, Texas Children’s Hospital, has now adopted Covalon’s advanced post operative dressing.

Through the use of advanced technology designed to protect patients from setbacks to healing like surgical site infections, patients and their parents can have their best chance at recovery and freedom from some of the risks that come with surgery.

Key takeaways:

  • Surgical site infections (SSIs) occur within 30 days after surgery and are caused by bacteria that can infect surgical wounds in the surrounding tissue, right down to the muscles or organs that were involved in the surgery.
  • SSIs are a leading cause for readmission to hospital with 3% of patients with SSIs dying as a consequence.
  • SSIs can be prevented through surgical safety checklists, strict hygiene protocols, monitoring and the right wound care technology.

Eliminating Surgical Site Infections 

While healthcare practices and protocols differ between every hospital and surgical team, the use of advanced technology to improve post-operative wound care is one of the best ways any hospital or care team can strengthen their infection prevention program. 

The Heart Unit at Texas Children’s Hospital sought to do just that, by introducing a new transparent antimicrobial soft silicone postoperative dressing on pediatric congenital heart surgery patients. 

As part of this quality improvement project, the Heart Unit ran a trial to strengthen post operative wound care and infection prevention practices specifically by trialing SurgiClear, Covalon’s dual-antimicrobial clear silicone adhesive dressing used to cover and protect wound sites. 

Dual antimicrobial action 

SurgiClear has two antimicrobials - chlorhexidine and silver, killing 99.99% of microorganisms associated with SSI and suppressing their regrowth for up to 7 days. 

Transparent monitoring and care

The transparency of SurgiClear allows clinicians to view post-operative incisions without the need to remove the dressing. 

Minimizing pain and trauma

SurgiClear’s soft silicone adhesive minimizes pain to patients and trauma to wounds. 

During the course of the one-year trial, infection rates steadily declined. During the course of the one-year trial, the SSI rate steadily declined. Use of the dressing had a positive impact on patients and providers, helping the team to achieve a 0% SSI rate.

The trial involved the use of SurgiClear post-operatively on a total of 600 patients ranging in age from 2 months to 66 years that had congenital heart surgery.

Key highlights include:

  • Infection rates steadily declined over the course of the project, reaching 0 infections after 1 year
  • The transparency of SurgiClear reduced the number of dressing changes, in turn reducing exposure and manipulation of the healing wound
  • Application of SurgiClear was successful across a wide range of age groups and incision types
  • There have been no adverse events or cases of compromised skin integrity
  • The low-profile transparent design of the SurgiClear dressing was well received by patients' parents and caregivers, empowering them to monitor for signs of complications

The Cost of Surgical Site Infections 

Researchers estimate that in the United States, approximately 55% of SSIs are preventable and although there are many potential sources of infection during a patient's perioperative experience, improving postoperative wound care protocol with an advanced technology benefits both patients and hospital resources. 

Children with SSI after cardiothoracic surgery ("CTS") have an associated increase in hospital costs of US$136,950 per case and hospital length of stay of 9.5 days per case. The economic burden posed by SSI stresses the importance of infection control surveillance, exhaustive preventative measures, and identification of modifiable risk factors.

Sophia C. Bailey, MSN, BSN, RN, CNOR, of Texas Children's Hospital in Houston, shared her perspective on the importance of preventing SSIs. 

"Parents of our pediatric heart surgery patients are often concerned and worried about their child's upcoming surgery. However, surgery is only one critical element of the post-operative journey. Healing and prevention of surgical site infection are paramount for patient outcomes. Since we began using SurgiClear, we have had excellent results maintaining the immediate perimeter of our incisions. This initiative has improved healing and prevention of wound contamination and infection, resulting in much-needed peace of mind for both parents and clinicians."

Caring for Incisions from Hospital to Home 

Caring for an incision post-op begins in the hospital and often continues at home. 

Proper incision care, like protecting the site from bacteria and from reopening the wound, is critical to promoting undisturbed healing, minimizing scars and healing infection free. 

Amongst hand hygiene and monitoring for signs of infection, dressings play a critical role in wound care and creating a barrier to bacteria as your skin heals. 

Look for a dressing that:

  • Is transparent to allow for easy monitoring and fewer removals 
  • Contains a soft silicone adhesive to minimize pain and prevent medical adhesive-related skin injuries (MARSI)
  • Has antimicrobials like chlorhexidine and silver to kill bacteria associated with SSIs
  • Is the right size for the incision, covering the entire area 

With the right technology care providers and patients can be confident that they have the best tools and dressings they need to experience the surgical outcomes everyone is hoping for. 


John Hopkins Medicine - Surgical Site Infections

Patient Safety Network - Surgical Site Infections

AORN Journal - Using a Transparent Antimicrobial Soft Silicone Dressing to Prevent Surgical Site Infections After Congenital Heart Surgery

Infection Control & Hospital Epidemiology - 

Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs

World Journal for Pediatric and Congenital Heart Surgery - Surgical Site Infection After Pediatric Cardiothoracic Surgery

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