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To determine the validity of re-sternotomy for the management of recurrent post-sternotomy mediastinitis. A multicenter retrospective review of all patients with post-sternotomy mediastinitis who underwent re-sternotomy from January 2000 to March 2007 was performed. Patients who were admitted for a second-time mediastinitis were included in this study. Patients with a previous sternal infection were excluded. Those with a history of hypertension, diabetes mellitus and previous cardiovascular surgery were also excluded. Patient outcomes included risk factors for recurrent mediastinitis, post-operative complications and in-hospital mortality. Univariate and multivariate analysis were performed. A total of 22 patients with a history of previous sternotomy and mediastinitis were identified. The mean age was 56 years (range: 32-80 years). All of the wounds were infected due to anastomotic leaks. The median interval from initial to second operation was 4 months (range: 1-39 months). Post-operative complications occurred in all patients, including new wound dehiscence in 5 (23%), renal failure in 2 (9%) and myocardial infarction in 1 (4%) patient. However, there were no cases of pericardial window infection or sternal osteomyelitis. Survival was 70% (15/22) at 90 days and 50% (11/22) at 1 year. Risk factors for recurrent mediastinitis were previous mediastinitis (hazard ratio [HR]: 6.96, 95% confidence interval [CI]: 2.04-23.80), concomitant cardiac surgery (HR
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