Abstract: Achieving primary closure of a flap may not always be possible initially. Current controlled closure

techniques exert uniform pressure across a wound, which is unsuitable for a flap, as it can induce ischemia

in vulnerable areas. Using Ligaclips to secure tissue advancement along mattress sutures offers both the

ease of expansion, like running sutures, and the ability to moderate in tension in discrete areas, like

interrupted sutures. The cases the poster highlight variations of how this technique can be applied to close

wounds boarded by vulnerable tissues such as flaps. We concluded that the use of ligaclips in conjunction

with mattress sutures in the controlled closure of defects around flaps is simple and fast, enabling greater

control over the forces exerted over discrete areas, minimising the risk of compromising vulnerable tissues.