Perforator flap

A flap raised on a small vessel that pierces the deep fascia to supply the skin, leaving the underlying muscle intact. Conceptualised by Koshima and Soeda in 1989.

Related terms

• Procedure

  DIEP flap

  Lower abdominal skin and fat used to reconstruct a breast on a perforator pedicle, without sacrificing the rectus abdominis muscle. The autologous standard for breast reconstruction.

• Procedure

  ALT flap

  A versatile soft-tissue flap from the lateral thigh, supplied by the descending branch of the lateral circumflex femoral artery. The most adaptable workhorse flap in modern reconstruction.

• Procedure

  SCIP flap

  Thin groin-area skin flap raised on a small perforator using supermicrosurgical technique, with a donor scar that hides in the bikini line. Described by Koshima in 2004.

• Anatomy

  Perforator

  A small blood vessel that pierces the deep fascia to supply the skin and subcutaneous tissue from a deeper source artery. Classified by route — direct (straight from a main trunk through fascia), septal (through intermuscular septa), or musculocutaneous (through a muscle before reaching skin). Clinically usable perforators measure 0.5-1.5 mm.

Articles mentioning this term

1. Expert blog · 9 May 2026

   Free tissue transfer: principles, applications, and current practice

   Conceptual overview of free flap surgery — what a free flap is, where the technique came from, the workhorse flaps, outcomes, and current directions.

2. Expert blog · 9 May 2026

   Wolne płaty

   Konceptualny przegląd chirurgii wolnego płata — czym jest, skąd pochodzi, płaty robocze, wyniki i kierunki rozwoju.

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