Joseph Linda, Jeanmonod Rebecca K
St. Luke's University Hospital and Health Network, Bethlehem, Pennsylvania.
West J Emerg Med. 2014 Mar;15(2):134-6. doi: 10.5811/westjem.2013.11.19344.
Deep sternal wound infections (DSWI) are infections of the sternum, mediastinum, or the muscle, fascia and soft tissue that overlie the sternum, typically occurring within a month of cardiac surgery. They are infrequent though severe complications of cardiac surgery. Diagnosis is made by the clinical presentation of fever, chest pain, or sternal instability in the setting of wound drainage, positive wound cultures, or chest radiographic findings. We describe the case of an elderly man presenting 6 months after cardiac surgery with DSWI. Due to the atypical nature of such a late presentation, definitive therapy was delayed. Given a severely ill patient with multiple risk factors for poor wound healing, the clinician must maintain a high index of suspicion for DSWI despite a delayed presentation.
深部胸骨伤口感染（DSWI）是指胸骨、纵隔或胸骨上方的肌肉、筋膜及软组织发生的感染，通常在心脏手术后一个月内出现。它们是心脏手术中虽不常见但严重的并发症。诊断依据伤口引流、伤口培养阳性或胸部影像学检查结果，结合发热、胸痛或胸骨不稳定的临床表现来做出。我们描述了一名老年男性在心脏手术后6个月出现深部胸骨伤口感染的病例。由于这种延迟出现的情况具有非典型性，确定性治疗被推迟。鉴于该患者病情严重且存在多种伤口愈合不良的危险因素，尽管出现延迟，临床医生仍必须对深部胸骨伤口感染保持高度怀疑。
