J Reconstr Microsurg
DOI: 10.1055/s-0040-1716387
Review Article

In Pursuit of the “Perforator” in the Perforator Skin Flap

G. Ian Taylor
1  Taylor Lab Department of Anatomy and Neurosciences, Reconstructive Plastic Surgery Unit, University of Melbourne, Royal Melbourne Hospital, Parkville, Victoria, Australia
Geoffrey G. Hallock
2  Division of Plastic Surgery, Sacred Heart Campus, St. Luke's Hospital, Allentown, Pennsylvania
› Author Affiliations


Another congress of the World Society for Reconstructive Microsurgery (WSRM) this past year in Bologna was magnificent not just for the presentation of so many keynote lectures by the giants of our field nor the novel and innovative ideas shown by those who will someday follow in those footsteps, but by making all of us realize how many capable microsurgeons there are now practically everywhere in this world, doing incredibly important surgical management of challenges that previously were unmet and resulted in sheer devastation for so many of our patients. How much we are the same in our goals, aspirations, and abilities could not be overlooked, but it is amazing how much we also want to learn more together—each relying on the other. To do so, we must not forget our origins as we appropriately plan for the future. All this we philosophized in our WSRM panel on lower extremity reconstruction, while emphasizing on the surface the perforator flap that at the least today has caught everyone's attention. In this overview to follow, we once again tell two stories, starting with the beginnings of the concept of flaps in showing how the nomenclature has evolved over time according to our various surgical manipulations. Often overlooked, though, is a parallel timeline by the anatomists who have better elucidated the circulation to these flaps, where it will become obvious that often long ago the existence of perforators was recognized by them long before known by the surgeons. At least today, these two paths have at least temporarily intersected. Our pursuit of the “perforator” in the perforator skin flap has come full circle, following the course of the history of the flap itself—a pursuit of excellence.


This work was presented in part at “Acute Soft Tissue Reconstruction in the Lower Limb Panel,” 10th Congress of the World Society for Reconstructive Microsurgery, Bologna, Italy, June 15, 2019.

Publication History

Received: 03 June 2020

Accepted: 15 July 2020

Publication Date:
06 September 2020 (online)

Thieme Medical Publishers
333 Seventh Avenue, New York, NY 10001, USA.