Introduction: Omental flaps are used for coverage following surgical management of poststernotomy mediastinitis. They have been associated with significant postoperative complications, including pain and diaphragmatic hernias.
Case Presentation: We present a case of a 78 year old woman who underwent multiple debridements for mediastinitis and required omental flap creation for coverage. She presented with a large thoracic wall hernia and associate dyspnea. She underwent open ventral incisional hernia repair with no diaphragmatic hernias. After surgery, she required reoperation due to superficial wound dehiscence. She tolerated the surgery well with appropriate wound healing.
Conclusion: Omental flaps are an appropriate surgical option to cover defects following sternotomy. Although complications include diaphragmatic hernias, the hernia must be thoroughly evaluated to ensure for no additional defects.