65-year-old man with mediastinitis caused by Staphylococcus aureus. After aortic reconstruction surgery with a Dacron® prosthesis, the prosthesis was exposed 12 days after surgery, with a high risk of dissemination of local infection and the possibility of rupture due to desiccation. Since it was decided to open the surgical wound, the patient was washed with physiological saline solution every 8 hours and treated with silver Sulfadiazine. The patient required continuous intubation from the day of surgery, maintaining haemodynamic stability thanks to the use of vasoactive drugs.
It was decided to restitute the chest wall with pectoral muscle flaps. After curettage of the sternum in the midline, a window was made in the upper end of the sternum (left margin), at the level of ribs 3a and 4a, to wrap the aortic prosthesis with the left pectoral muscle. The right pectoralis muscle was advanced over the sternum after further osteosynthesis with wires and then direct closure of the skin flaps. The patient remained in the ICU for 2 days with antibiotic treatment, and was then discharged to the ward without incident. Two years later he remains asymptomatic.

