[Brief introduction of perforator flap].

In 600 BC, the first pedicled direct cutaneous artery perforator flap-the supravicular artery perforator flap was harvested by Sushruta. In 1973, the first free perforator flap-the superficial circumflex iliac artery flap in the groin was reported by Daniel and Taylor. In 1982, the septocutaneous perforator flap was reported by academician Zhong Shizhen. In 1989, the misculocutaneous perforator flap was reported by Koshima. Reviewing the history of flap surgery, there was a fact that the main evolutionary line was the course of perforator flap. In the future, the clinical application of the traditional random flap (reticulated blood supply flap) and traditional axial flap will be more and more less, whereas the clinical application of perforator flap, especially the direct cutaneous perforator flap and the special type of perforator flap will be more and more extensive.

21 year follow up of a DIEP (deep inferior epigastric perforator) flap: a tale of a "nulltiple".

Since the first description of "The free abdominoplasty flap for breast reconstruction" by Hans Holmstrom in 1979, [see Ref. 1] the use of lower abdominal tissue has revolutionised reconstruction of the breast. DIEP (deep inferior epigastric perforator) free flap offers an abundance of reconstructive material, aesthetically-pleasing results and limited donor site morbidity. We report our first case of breast reconstruction with what presently is known as DIEP flap, performed in 1991 at St. Andrew's Centre for Plastic Surgery and Burns in Essex, The United Kingdom and the recent follow up results. We also discuss the historical events surrounding the evolution of this unpublished case and other documented cases.