[About perforator flaps…20 years later].

Despite the birth of reconstructive surgery 2000 years ago, the main advances in this field appeared in the second half of the 20th century. Born in Asia, it is from that same continent that the last improvement has occurred through the perforator flap concept. Combining advances in the understanding of cutaneous blood supply and advances in surgical instrumentation to optimize the reconstruction while reducing morbidity is gradually becoming a reality. Twenty years after the first perforator flap described by Koshima and Soeda, the authors review the history, the concept and nomenclature of these flaps. Furthermore, through an analyze of the international literature, the authors attempt to achieve an assessment of the reliability and morbidity of perforator flaps after 2 decades of existence.