External fixator immobilisation of a pedicled groin flap

BACKGROUND Pedicled fl aps can still be a useful part of the reconstructive surgical toolbox. Their stabilisation is crucial to prevent shearing forces causing fl ap failure. This can be challenging using traditional dressings so different stabilisation methods have been described including plaster of Paris and topical negative pressure dressings. These are disadvantaged by limiting fl ap observations and wound care. External fi xation was fi rst described for this indication nearly half a century ago1–3 but recently, we could only fi nd a Chinese case series using this technique published, with only its abstract in English.4 We aim to illustrate its effective use in giving an excellent immobilisation, fl ap care and outcome. DISCUSSION External fi xation to immobilise pedicled fl aps provides robust stabilisation of the fl ap with excellent access for observation and wound care. Ease of application and removal facilitates fl ap management as well as defi nitive patient rehabilitation and hand therapy. Potential risks of bone fracture, muscle cramps and pin site infection can be minimised by appropriate placement/adjustment, wound care and patient counselling.5 In our experience, external fi xation fl ap stabilisation is safe and effective, and we hope other surgeons will publish their outcomes using this technique.