Perforators in the Leg: Why It Is Important for Orthopaedic Surgeons to Know

Skin blood supply and the angiosome concept Blood supply to the skin originates from the main artery artery of the leg. They give out branches that pass through the muscle or septum before perforating the deep fascia to supply an area of skin. This small territory of skin that is supplied by a perforator vessel is called an angiosome. The perforators are quite constant in their location and have been mapped out by many researchers. Perforators flaps are designed based on these perforating vessels as pivot points. By using a hand-held Doppler ultrasound, surgeons are able to identify the approximate location of the perforators, and reliably raise a flap. Identifying the location of the perforators is therefore important for orthopaedic surgeons to avoid damage during wound extension or undermining for skin closure.