Vaska P L
AACN Clin Issues Crit Care Nurs. 1993 Aug;4(3):475-83.
Sternal wound infections are a major cause of morbidity and mortality in patients undergoing cardiac surgery. They occur in 1% to 3% of patients who undergo open-heart surgery and carry a 20% to 40% mortality rate. Sternal infections can range from minor, superficial infections to open mediastinitis with invasion of the sternum, heart, and great vessels. Staphylococcus species are responsible for the majority of sternal infections, but environmental sources can cause infections by other organisms. The common signs and symptoms of mediastinitis are fever, leukocytosis, sternal instability, drainage, and pain. Several risk factors exist for sternal wound infection, with bilateral internal mammary artery bypass grafting in diabetic patients being the most common. Treatment entails surgical debridement with either closed irrigation, open-wound packing, or muscle or omental flap procedures, as well as antibiotic therapy. Some simple procedures help limit the development of sternal infections in certain patients.
胸骨伤口感染是心脏手术患者发病和死亡的主要原因。在接受心脏直视手术的患者中，其发生率为1%至3%，死亡率为20%至40%。胸骨感染的范围可从轻微的浅表感染到伴有胸骨、心脏和大血管侵犯的开放性纵隔炎。葡萄球菌属是大多数胸骨感染的致病菌，但环境来源可导致其他生物体引起感染。纵隔炎的常见体征和症状包括发热、白细胞增多、胸骨不稳定、引流和疼痛。胸骨伤口感染存在多种危险因素，其中糖尿病患者双侧乳内动脉搭桥术最为常见。治疗包括手术清创，可采用闭式冲洗、开放伤口填塞、肌肉或网膜瓣手术，以及抗生素治疗。一些简单的程序有助于限制某些患者胸骨感染的发生。
