I remember seeing old black and white pictures of something similar to this from World War I, but I never saw any explanation of what was happening.
http://ihasanupload.com/uploadimages/5173001226592611434.jpg (strange medical procedure, although there’s a towel it’s also probably also NSFW)
I’m guessing they are trying to regrow something?
I believe it’s simply called a skin tube. The idea is that they will continually stretch out a section of the patient’s own skin while it still has blood flow, and when it is large enough it may be grafted over a burn wound or similar injury with minimized risk of rejection.
Seems I narrowly missed the edit window. I just noticed from a search that today a similar technique is also used for esophagus replacements, so that may well be what your picture displays, but as far back as WWI it was only used for skin grafts as far as I know.
(for those who don’t want to click)
It’s an image of a dude with a tube of flesh connecting his left palm to his left hip, and there is a row of stitches going down to his knee.
He’s like a tea pot now!
It appears like they took a thigh-length strip of flesh a few inches wide, formed it into a tube, left it attached to the hip, sewed it to his palm, and then stitched together the edges of the long wound on his thigh.
It looks like they are using a full thickness graft of skin, muscle and blood vessels from the thigh to use to replace the thumb of the left hand.
It stays attached to the donor site to preserve the blood flow until the graft is properly established.
The hand bone’s connected to the hip bone?
Its called a tube pedicule, and was an early piece of reconstructive surgery. By rolling the flap of excised tissue into a tube, the risk of infection is reduced (original attempts tried just using an open flap, and patients invariably died from infection), and by retaining the blood supply from the original site, the graft stayed alive until the blood supply integrated into the graft site. In some cases, the tube would be “walked” up the body to the eventual destination.
These days, microsurgical techniques allow the integration of blood supply, so this technique is rarely used.
Si (who recently watched Blood and Guts: A History of Surgery on the BBC)
Cool. Thanks for the information, and also for the series recommendation.
That is information that I may need one day… this is one reason I keep coming back to the dope.
It’s a tube pedicle. It works as described by previous posters.
Regarding this picture, I don’t think it’s replacing the left thumb - the thumb is visible on both hands. Tube pedicles are also used in phalloplasty and phallic reconstruction, so that may be what’s going on in the picture.
If you can see the native left thumb, your eyes are better than mine (not saying much…).
Because the left hand is actually attached to the thigh, and because this is an exceedingly awkward thing to happen (putting on a shirt, e.g.), and because the stitch line extends to the thenar eminence of the left hand, perhaps the patient had a degloving injury of the left thumb and the pedicle is being used to cover the degloved area. There’s no other reason to attach the hand (i.e. for a pedicle being used somewhere else). This is a pretty common industrial injury from rollers and the like, which jerk the skin off. I’ve seen the whole forearm degloved…
It’s not likely a complete thumb amputation since it would be easier to substitute a big toe for that.
Still, there’s an awfully big incision on the thigh so I wonder if some other skin is missing off the volar forearm or something. Or maybe a resident did the surgery. Stitches look kind of lame.
There was a really cool thread about this sort of thing a few years ago.
Seven’s Meat Carrot story in that thread is really gross and awesome and highly recommended.
“Degloving”. Dear Og. :: shudder ::
That’s much more upsetting that the picture, which is more ‘odd’ than ‘eww’.
I’m with Sunspace - degloving injuries squick me out. The thought that something can peel off a finger (or even a whole forearm) leaving meat and bone makes me shudder. I don’t really even like wearing a ring, after seeing a medical show where some guy jumped up and grabbed an overhead shop sign, caught the edge of the sign with a ring when he let go, and degloved his finger with his own bodyweight.
Si
