الفهرس 
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Abstract
Management of mediastinits depends upon the time of diagnosis. When the diagnosis is established within 20 days from the original surgical procedure, the infection can be controlled by the simple approach of debridment followed by closed antibiotic or Betadine irrigation. Other line of management is debridment and irrigation of the wound with Betadine then the wound is drained by using Ridon catheters with high negative pressure (without irrigation). If the sternal edges are stable we can separate the two recti in the medline subxiphoid followed by insertion of one or two retrosternal drainage catheter. Antibiotics are given, and the drains are removed after disappearance of discharge.
When the diagnosis of mediastinitis is delayed (>20 days), so debridment by omental transposition or muscle flaps transposition is the best technique.
Debridment and open packing technique was used in the past with antibiotic or Betadine irrigation followed by delayed surgical closure or closure over time by a process of secondary intention or granulation. But now a day the line of choice in management of mediastinitis is debridment followed by flap transposition whether muscle flap or omental flap.