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Related Experiment Video

Updated: Oct 23, 2025

A Model of Free Tissue Transfer: The Rat Epigastric Free Flap
10:10

A Model of Free Tissue Transfer: The Rat Epigastric Free Flap

Published on: January 15, 2017

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Tips on Raising Reliable Local Perforator Flaps.

Mark W Ashton1,2,3

  • 1Department of Surgery, The University of Melbourne, Parkville, Victoria, Australia; Taylor Laboratory, Department of Anatomy, The University of Melbourne, Parkville, Victoria, Australia.

Plastic and Reconstructive Surgery. Global Open
|August 23, 2021
PubMed
Summary
This summary is machine-generated.

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Increasing Perfusion Pressure Does Not Distend Perforators or Anastomoses but Reveals Arteriovenous Shuntings.

Plastic and reconstructive surgery. Global open·2020
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The Functional Anatomy of the Ophthalmic Angiosome and Its Implications in Blindness as a Complication of Cosmetic Facial Filler Procedures.

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The quadriceps Femoris allograft as an extension of the Angiosome concept: A cadaveric-based anatomical feasibility study.

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The Role of Anastomotic Vessels in Controlling Tissue Viability and Defining Tissue Necrosis with Special Reference to Complications following Injection of Hyaluronic Acid Fillers.

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Angiosome-Based Allografts: Vascularized Composite Allotransplantation for Tailored Subunit Reconstruction with Volkmann Ischemic Contracture as a Case in Point.

Plastic and reconstructive surgery·2017

Local perforator flaps offer superior plastic surgery reconstructions. Advances in understanding integumentary blood supply now allow reliable perforator flap design and tissue transfer with predictable outcomes.

Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Vascular Anatomy

Background:

  • Local perforator flaps are preferred for aesthetic reconstructions due to superior outcomes and reduced patient morbidity compared to distant tissue transfers.
  • Challenges in utilizing local perforator flaps include accurately locating supplying perforators and ensuring adequate blood supply for tissue transfer.

Purpose of the Study:

  • To highlight recent advances in understanding integumentary vascular anatomy for improved local perforator flap design.
  • To explain the practical application of these advances in reliably raising local perforator flaps.
  • To provide guidance on potential pitfalls and complications associated with perforator flap surgery.

Main Methods:

  • Reappraisal of integumentary blood supply and perforator anatomy.

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Last Updated: Oct 23, 2025

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  • Inexpensive and accurate methods for locating perforators at the deep fascia.
  • Understanding of anastomotic vessels between perforators to predict safe tissue elevation.
  • Strategic "delay" techniques to manipulate vascularity for flap design.

    • Main Results:

    • Accurate and inexpensive identification of perforators without "high tech equipment" is now possible.
    • Reliable prediction of the amount of tissue that can be safely raised on a single perforator.
    • Ability to design flaps of any dimension and tissue composition through vascular manipulation.
    • Safe local or distant transfer of designed flaps.

    Conclusions:

    • Recent advances in vascular anatomy understanding enable reliable and predictable local perforator flap surgery.
    • These techniques simplify procedures, reduce patient morbidity, and allow for greater design flexibility.
    • The article provides practical insights, pearls, and pitfalls for successful perforator flap reconstruction.