Objective: The study is simply a series of observation of results with one form of treatment which is the use of pectoralis major myocutaneous advancement flap as a definitive mode of treatment of post median sternotomy mediastinitis following open-heart surgery. Methods: Ten patients underwent treatment of sternal wound complication following open heart surgery with pectoralis major muscle flap. It is a retrospective study from May 1999 to May of 2001. The approach, however, does not represent the entire experience with such wounds at our institution during that time.Results: All patients did well postoperatively except three cases who experienced post-operative morbidity with the most common untowards sequela being seroma formation. The overall follow up ranged from 6 months to 24 months with an average 16 months with no evidence of recurrent infection. The mortality rate was zero percent.Conclusion: Treatment of infected sternotomy wounds continue to be controversial. In fact we prefer to use aggressive early surgical debridement and combined sternal closure with bilateral pectoralis major advancement flaps, as it is simple procedure associated with low morbidity and no mortality. It is now the preferred approach for the treatment of postoperative suppurative mediastinitis.