الفهرس 
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Abstract
The perforator flaps in lower limb reconstruction are a valuable option in the armamentarium of a reconstructive surgeon.This is a versatile technique and with decreased donor site morbidity limited to a single body area. These flaps do not involve sacrifice of any of the main arteries.
They can cover very distal defects of the leg. There is a specific like to like soft tissue replacement leading to a better cosmetic and reconstructive outcome.
The operative time taken for perforator flaps is not significantly
higher than that for other fasciocutaneous flaps.
Disadvantages of these flaps are that they have a limited role in larger defects, degloving injuries, and variable location of the perforators away from the soft tissue defect can sometimes be a hurdle.
The main drawback of the perforator flaps however is the higher risk of venous congestion. Because the perforator venouswall is much thinner than the perforator arterial wall, it has a greater chance of venous congestion when rotated up to 180 degrees.
The proximal part of the flap which is used for defect coverage
Sometimes suffers from partial skin necrosis due to venous congestion. The problem of venouscongestion can often be prevented with adequate
Dissection, loose suturing, post operativedependent drainage and massage.
Perforator flaps may represent a good alternative to the free flaps in the areas were other local reconstructive procedures are not possible.
We believe that when the characteristics of the defect are suitable for treatment, this technique should be regarded as one of the possible and valuable reconstructive option.