A procedural sheath holding device includes a base member and a securing member. The base member is positionable in contact with an outer skin surface adjacent to an incision. The securing member is attached to the base member and includes a securing portion operable to releasably secure a procedural sheath in a fixed axial position relative to the skin surface when a vascular closure device is inserted through the procedural sheath to seal the incision. The securing member may be pivotal relative to the base member.