A tube pedicle procedure is primarily of historical interest as advances in vascular surgery and microsurgery have made it almost obsolete.
The skin and soft tissue of the abdomen with an identified blood supply is formed into a tube (Figure 1). After the tube heals, one end of the pedicle is severed from the abdomen and attached to the full thickness wound site (Figure 2). The arm is immobilized against the abdomen for weeks to allow the blood supply from the pedicle to heal the flap covering the wound, after which it is disconnected.
This procedure was designed to cover severe war wounds at a time when antibiotics were not yet available, as wrapping the flap in a tube minimized infection.
Although currently rarely indicated because of the ability to transfer full thickness flaps, it may still be of occasional use in patients with multiple severe injuries. Additional information can be found here.
Disclaimer: HandLab’s What Do You See? is intended to be an informal sharing of practical clinical ideas; not formal evidence-based conclusions of fact.