Monitoring surgical wound characteristics in congenital heart surgery using the swat tool at the Cardiovascular Center, E Hospital, 2026

Abstract

Objectives: To describe the characteristics of surgical wounds in patients undergoing congenital heart surgery at the first dressing change, postoperative day 5, and at discharge using the Surgical Wound Assessment Tool (SWAT), and to identify factors associated with wound status (based on SWAT scores) in these patients.

Methods: A cross-sectional descriptive study was conducted on  surgical wounds of patients undergoing congenital heart surgery at the Cardiovascular Center, E Hospital, from December 2025 to April 2026.

Results: 58% of patients were male and 42% were female, with children under 5 years old accounting for the majority (84%). At the first dressing change, 50% of surgical wounds had serosanguinous discharge, 82% showed edema, and 92% showed erythema. By the second dressing change, 90% of wounds were dry/moist, and the rate of edema decreased to 14%. At the time of discharge, 100% of wounds were completely dry. Wound characteristics changed significantly across the three assessments (P < 0.05), except for the wound location. The mean SWAT score decreased progressively across the three assessments to 6.74 ± 2.12, 4.98 ± 3.33, and 3.94 ± 1.15, respectively (P < 0.001). The surgical site infection (SSI) rate was 12%. Factors significantly associated with SSI included erythema, non-approximated wound edges, and abnormal quantity and nature of discharge (P < 0.05).

Conclusion: The characteristics of the surgical site are consistent with the wound healing process. The surgical site infection rate is 12%. Related factors include: prolonged operative time and manifestations such as wound edges, erythema, edema, and the volume and characteristics of wound drainage.