Is Skin Nourishment Always Possible Through The Perforators In A Musculocutaneous Flap?

We present a case with vertical rectus abdominis myocutaneous free flap in which deep inferior epigastric perforators does not nourish skin paddle of the flap. The skin paddle of musclocutaneous flaps is nourished by musculocutaneous perforators originating from the main vascular system of the muscle. The skin paddle of rectus abdominis flap is also supplied by musculocutaneous perforators of deep inferior epigastric artery (1). Cutaneous perforators end directly within the skin. Their origin may be either from the source artery or from the subcutaneous or fascial brances (2).