Clinical Validation

Clinical Evidence

The Shira 3-Jaw Microvascular Clamp has been independently evaluated in three peer-reviewed publications across institutions in India and the United States. Each study consistently demonstrates reduced anastomosis time, elimination of backwalling, and a measurably shallower learning curve versus standard Acland clamps.

3 Publications
0% Backwalling rate
(vs 30.8% Acland)
p<0.001 Anastomosis time
improvement (RCT)
RCT Highest level
of evidence

Evidence Summary — Across All Three Studies

Outcome Finding Best p-value
Anastomosis time Significantly reduced vs Acland across all three studies p < 0.001
Backwalling / improper bites 0% with Shira vs 30.8% with Acland
Posterior wall access No clamp flip required in any case — confirmed across all studies
Clamp flip required 0% with Shira vs 38.5% with Acland
Ease of use rating Significantly higher surgeon rating with Shira p < 0.001
Need for assistance Significantly lower with Shira clamp p < 0.001
Highest study level achieved Randomized Controlled Trial (AIIMS Jodhpur, 2023)
Plastic & Reconstructive Surgery Oct 2022 · Vol. 150, Issue 4

Novel Microvascular Clamps to Aid Trainee Surgeon Education: Smarter Than Acland Micro Clamps?

Authors: Shivangi Saha, Arbab Mohammad, Joseph M. Escandón, Shashank Chauhan

Institutions: AIIMS New Delhi; Aarupadai Veedu Medical College, Puducherry; Division of Plastic & Reconstructive Surgery, University of Rochester Medical Center, New York, USA

DOI: 10.1097/PRS.0000000000009530  ·  PMID: 35960914  ·  Published in Plastic and Reconstructive Surgery — flagship journal of the American Society of Plastic Surgeons


Study Design & Key Results

10 plastic surgery trainees (6–24 months of microsurgery training) performed 25 vascular anastomoses — 12 with the Shira 3-Jaw clamp, 12 with standard Acland clamps — during live free flap and flexor tendon repair procedures.

0%

Backwalling / improper bites with Shira vs 30.8% with Acland

0%

Clamp flipping needed with Shira vs 38.5% with Acland

p = 0.007

Anastomosis time significantly shorter with Shira

p < 0.001

Need for surgical assistance significantly lower with Shira

JPRAS Sep 2022 · Vol. 75, Issue 9

A novel, innovative clamp with vessel eversion feature for end-to-end microvascular anastomosis

Authors: Aakash Kohli, Prakash Kala, Aniket Dave

Institutions: Department of Oral & Maxillofacial Surgery and Department of Plastic Surgery & Burns, AIIMS Jodhpur

Ethics Approval: AIIMS Jodhpur IEC Ref. AIIMS/IEC/2021/3691

DOI: 10.1016/j.bjps.2022.06.068  ·  PMID: 35851497


Key Findings

First

Clinical report of 3-jaw vessel eversion design in microvascular reconstruction

Full

Posterior wall visibility achieved without repositioning or flipping the clamp

21.7%

Backwalling rate with Acland — directly eliminated by Shira's eversion mechanism

19.6%

Incomplete bite rate with Acland — eliminated by full lumen visibility under Shira clamp

"The device achieves vessel eversion and maintains the vessel wall open under occlusion, providing unobstructed visualization of the posterior wall without the need for clamp repositioning."

— Authors, JPRAS 2022
JPRAS Dec 2023 · Vol. 87 Randomized Controlled Trial

Efficacy of novel, three jaw adventitia holding microclamps compared to Acland microclamps in patients undergoing end-to-end microvascular anastomosis: A randomized control trial

Authors: Aakash Kohli, Aniket Dave, Pawan Dixit, Deepti Katrolia, Pravin Kumar, Prakash Chandra Kala

Institutions: All India Institute of Medical Sciences (AIIMS) Jodhpur & Apollo CBCC Cancer Care, Ahmedabad

DOI: 10.1016/j.bjps.2023.09.022  ·  PMID: 37812846


Study Design

Single-centre, parallel-group randomized clinical trial. 30 patients, 1:1 allocation — TADH (3-Jaw) clamp group vs Acland clamp group. Primary outcome: arterial and venous clamping and suturing time. Secondary outcomes: ease of use, need for clamp flipping, need for assistance, flap survival.

p < 0.001

Artery clamp + suture time significantly faster with 3-Jaw

p < 0.001

Vein clamp + suture time significantly faster with 3-Jaw

0

Clamp flips required with 3-Jaw in any case throughout the entire trial

p < 0.001

Ease of use significantly higher with 3-Jaw (Chi-square 9.867)

p < 0.001

Need for assistance significantly lower with 3-Jaw (Chi-square 19.286)

"This study found TADH microclamps to be faster, easier to use, and clinically efficacious in reducing the anastomosis time compared to those of the Acland clamps."

— Authors' conclusion, JPRAS 2023 RCT

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