Mediastinitis and sternal dehiscence with osteomyelitis is a devastating complication of the median sternotomy. Historically, closure of large sternal wounds had required more tissue than conventional bilateral pectoralis major flaps. Additional flaps had traditionally been used to cover the caudal one third of the wound. To avoid this added donor site morbidity, we have applied a new technique of splitting the turnover pectoralis major flap into superior and inferior leaves. The contralateral pectoralis major advancement flap is then inset between these two leaves. We have applied this technique in 15 cases at our institution between February 5, 2000 and July 5, 2003. Ages ranged from 1 month to 86 years. A single surgeon (DAS) performed all reconstructions. For the purpose of this paper, cardiac transplant patients and patients with ventricular assist devices were excluded from the series. Full, definitive closure was obtained in 13 cases. Skin dehiscence requiring a skin graft occurred in one case, and there was one post-operative death. We have found this technique to be reliable for closure large sternal wounds. This paper reviews the literature, describes our technique, discusses its advantages and limitations, and reviews our results.