Objective: To study the effect of flaps coverage as a definitive treatment of post median sternotomy mediastinitis following open-heart surgery. Methods: Ten patients underwent treatment of sternal wound complication following open-heart surgery; five with pectoralis muscle flap and five with omental flap. It is a retrospective study. The approach, however does not represent the entire experience with such wounds at our institution.Results: A few complications was noticed such as seroma happened in one patient in the pectoral group. The mortality rate was zeroConclusion: Treatment of infected sternotomy wounds continues to be controversial. In fact we prefer to use aggressive early surgical debridement and combined sternal closure with bilateral pectorlis major advancement flaps, as it is simple procedure associated with low morbidity and no mortality. It is now the preferred approach for treatment of postoperative suppurative mediastinitis. Although in some selected cases omental flap is a stronger choice.