Free-style Flaps: a Further Step Forward for Perforator Flap Surgery

Background: Technical advancements and increased experience with perforator flap techniques have allowed the harvest of flaps in a free-style manner.

Methods: To perform free or local island pedicled flaps using the free-style concept, one requires mature skills in retrograde dissection of vascular pedicles and in using a hand-held Doppler device. To keep the technique safe, certain principles should be remembered and are detailed in this article.

Results: The free-style flap concept provides unparalleled freedom when choosing local or distant soft tissues for reconstructing a defect.

Conclusions: Potential pitfalls during free-style flap harvest can be avoided if the presented principles are adhered to. Newer imaging modalities may prove useful for assessing vessels supplying any cutaneous territory.