Perforator flaps: current concept and definition

The ultimate evolution in plastic surgery with the recent introduction of supramicrosurgery has consisted of a description of a variety of new pedicled and free perforator vessel-based flaps which achieved a dramatic reduction of donor site morbidity when cmopared to traditional pedicled and free plaps. The term perforator became somewhat inapproprietely overused: in the recent literature it generally refers to direct cutaneous vessels, septocutaneous vessels, musculocutaneous branches running through muscle and fascia and also to any vessel found above the fascial plan. As recently emphasized by some influential authors the need for a proper common nomenclature has now been raised in order to achieve universal consensus amongst microsurgeons. The authors agree that the definition of perforator flap should be restricted to any flap supplied by a musculocutaneous perforating vessel and propose an essential up-to-date literature selection