Recurrent post-sternotomy mediastinitis.

The use of muscle flaps or omentum flap combined with an appropriate anti-microbial regimen is the treatment of choice for patients with recurrent mediastinitis. Flap closure obliterates the large mediastinal wounds and prevents spreading of the infection to the aorta, heart, including the vascular coronary artery grafts, and other prosthetic materials. In addition, the use of muscle flaps or omentum flap provides the infected tissues with the essential blood supply including good concentration of intravenously administered antibiotics, and leads to early wound closure with sufficient chest stability and respiratory function.