Concept of Perforator Flap

The concept of perforator flap was first put forward in the late 1980s. It is an axial pattern flap of skin and subcutaneous tissue with small-diameter skin perforator vessel (perforator artery and perforator vein) as the pedicles (Fig. 2.1a). Perforator flap is a development in microsurgery and has advantages as flexible design, small wounds at donor site, convenient transfer and good appearance of recipient site etc. At the beginning, perforator flap developed slowly and failed to attract much attention. Then two milestone meetings in Ghent, Belgium (2001) and Yinchuan, China (2005) promoted the research and development of perforator flap. A large number of basic researches and clinical application of perforator flap were reported since. Series of symposia and forums focused as well as collections and works published on perforator flap have laid an important theoretical basis for the development of perforator flap and raised a great enthusiasm in its research. With the increase of new donor sites and wide clinical application, dispute over the concept and nomenclature of perforator flap emerged. At the third Summit of Chinese Microsurgical Perforator Flap held in Ningbo in September 2013, following a principle of “seeking consensus on major issues while reserving dissensus on minor issues”, some domestic experts in flap surgery made profound discussions about current concept of perforator flap in China and reached a consensus on issues as whether to carry deep fascia and superior source artery.