A pair of five-day flaps: early division of distant pedicles after serial cross-clamping and observation with oximetry and fluorometry.

In each of 2 recent patients with distant pedicles (one a groin flap and the other a cross-leg flap), we were able to perform the final division and detachment of the flap on the fifth postoperative day. Cross-clamping was used to create intermittent periods of ischemia. The periods of ischemia were progressively increased until the time of division. Fluorometry with intravenous fluorescein played a role in deciding when to divide the flap. The patients were discharged from the hospital on the sixth and seventh days, respectively. Trimming was done on an outpatient basis.