Sternoplasty with pectoral muscle and dermal flaps due to total loss of sternal bone tissue caused by osteomyelitis

Mediastinitis is a rare complication in our days, but when occurs it presents high mortality, especially in cardiovascular surgery services. When early treated, the cases with little involvement of the bony structures surrounding the mediastinum have a better outcome and the integrity of the chest wall is usually kept. When the bone, especially the sternum, is affected and sometimes completely destroyed by the infection (osteomyelitis), the difficulty for attaining a solid closing of the anterior mediastinum arises. In this circumstance, the cardiovascular surgeon needs to use, in many cases, concepts and techniques of reconstructive surgery to solve the complex situation created. In the case presented, superficial skin structures and the pectoral muscle are used for reconstruction of the chest wall after mediastinitis with osteomyelitis and total loss of sternal bone tissue.