Sternal wound complications may result from median sternotomy procedures following cardiothoracic surgery and can represent a significant management problem, for example, infections and dehiscence can increase hospital stay, morbidity and mortality. Morbidity from sternal wound dehiscence was close to 50% until recently, but with recent advances, including sternal fixation techniques and various reconstructive surgical options, this has improved. This article outlines the problems of wound dehiscence and delayed healing following median sternotomy and provides an overview of the pertinent management options.