A history of the development of muscle perforator flaps and their specific use in burn reconstruction

Only rarely does coverage in the burn patient require the use of a vascularized flap. However, when mandatory, a knowledge of all alternatives is essential because common donor sites may have been badly burned and unavailable. The recent development of the muscle perforator flap may prove to be another valuable option. These flaps are nourished by the familiar musculocutaneous perforators but differ in that their complete intramuscular dissection is required during flap elevation so that no muscle need be included with the flap. A review of six cases using muscle perforator free flaps specifically for burn reconstruction or rehabilitation demonstrates how the same large cutaneous territory of a musculocutaneous flap can still be captured while the muscle and therefore its function is preserved.