title: Devices for ischemic preconditioning of the pedicled groin flap.
abstract: BACKGROUND
  Early division of the pedicled groin flap can be achieved by using ischemic preconditioning. The goal of this study was to investigate the devices available for ischemic preconditioning and determine which device is the most effective and results in lowest patient discomfort.
  
  
  METHODS
  Rubber bands, custom-made Orthoplast sheets, long-nose locking pliers, intestinal clamps, and a pneumatic tourniquet device were used for ischemic preconditioning on 13 patients who sustained severe hand injuries with reconstruction of pedicled groin flaps. The devices were compared by using laser Doppler flowmetry and the patient's local pain levels.
  
  
  RESULTS
  Twelve of 13 flaps were successfully divided at a mean period of 8.3 days by using a custom-made Orthoplast sheet or a pneumatic tourniquet device. All devices except the rubber bands could result in a biologic zero flow level.
  
  
  CONCLUSIONS
  The pneumatic tourniquet device is the most desirable ischemic preconditioning device, having the advantages of excellent ischemic effect, easy application, and minimal discomfort.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan, Republic of China. minghueicheng@hotmail.com
authors.forename: M H
authors.initials: MH
authors.lastname: Cheng
authors.forename: H C
authors.initials: HC
authors.lastname: Chen
authors.forename: F C
authors.initials: FC
authors.lastname: Wei
authors.forename: S W
authors.initials: SW
authors.lastname: Su
authors.forename: S H
authors.initials: SH
authors.lastname: Lian
authors.forename: E
authors.initials: E
authors.lastname: Brey
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D005260:Female; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D019194:Ischemic Preconditioning / Q000295:instrumentation*; D017078:Laser-Doppler Flowmetry; D008297:Male; D010147:Pain Measurement; D013524:Surgical Flaps / Q000098:blood supply*; D013525:Surgical Instruments