World War I

“For many years, surgeons had used open pedicle flaps to bring skin and subcutaneous tissue from a distant donor site to the recipient area. The raw undersurface of the flap exuded blood and serum, requiring frequently dressings in addition to allowing infection to become established. Fibrosis and contraction were invariably, and thrombosis of the nutrient blood vessels was common. Many of these problems were solved by the tubing of the pedicle, which protected the flap from infection and thrombosis, in addition to preventing shrinkage and contraction. In 1916 and 1917, three surgeons independently developed and used the tubed pedicle flap: V.P. Filatov (Ukraine), Hugo Ganzer (Berlin), and Harold Gillies (England), who developed and perfected the technique (Brain, 161).