Perforator Flaps
A Perforator Flap is a flap (transplanted tissue) which depends on its vascular supply (blood flow and nutrients) on a perforator vessel.
A perforator vessel is a small vessel which branches off a larger/main blood vessel and perforates(penetrates through or tracks through) a muscle to reach the overlying skin and fat.
In traditional flap surgeries, this perforator vessel would be taken with the muscle through which it runs, because surgeons did not have the techniques to dissect these very fine vessels out of muscles. Therefore, muscles were sacrificed to ensure that flaps (transplants) would live.
Today we have the microsurgical techniques that allow us to free these perforator vessel, while leaving muscle intact. This is of tremendous importance because now instead leaving the patient with loss of support, weakness, and deformity, perforator flaps are no more traumatizing than skin incisions.
Perforator flaps are now the standard of care for cancer reconstruction in major microsurgical centres. Perforator flaps include: DIEP, ALT, TAP, TUG, IGAP, and SGAP flaps.
