Classification of perforator types

Authors: Rami Mossad Ibrahim, Magnus Obinah, Magnus Balslev Avnstorp MD, Peter Stemann, Birgitte Jul Kiil and Christian Kaare Paaskesen Med. Stud.

Classification of Perforator Types

Perforator flaps may be classified in several different ways. One classification is by the way the perforator courses from the source vessel to the deeper fascia and skin plexus; Either directly to the skin, through the intermuscular septum, through the muscle, as a branch of another larger vessel to muscle or skin. The flap is usually named after the specific perforating vessel.

Direct cutaneous perforator: Courses directly from source vessel to the skin, passing only through the deep fascia.

Direct Septocutaneous perforator: Courses through intermuscular septum before piercing the deep fascia to the skin.

Direct Cutaneous branch of muscular vessel: Courses directly to the skin from a vessel ending in a muscle without perforating either septa or muscle.

Perforating cutaneous branch of muscular vessel: As a sidebranch of a muscular vessel courses through the muscle before perforating to the skin.

Musculocutaneous perforator:Courses through muscle before piercing the deep fascia to supply the overlying skin.