Early division of pedicled flaps using a simple device: a new technique.

A simple occlusion clamp with screws used to achieve early division of two-staged, distant pedicled flaps is presented. The device is applied to the bridge of a distant flap on the 5th postoperative day and is gradually tightened. It was used on 20 consecutive pedicled flaps in 20 patients: 5 abdominal flaps, 4 superficial external pudendal artery (SEPA) flaps, 9 cross leg flaps, 1 groin flap and 1 medial arm flap. In 17 patients, the flaps were divided successfully between the 9th to the 14th day (Mean: 10 days). The device was removed in 3 patients when ischaemic changes became apparent; their flaps however survived completely and were divided after a longer interval. The principles on which the device works, the technique, feasibility, and advantages of using the device for early flap division are discussed.