Many new developments have taken place in the field, including the use of local perforator flaps, including free-style propeller flaps as well as the distal-based sural flap, which is effective for the lower extremity especially when microsurgical skills are unavailable. The editors, leading reconstructive surgeons and pioneers in the field of perforator flap surgery, have assembled a group of world-renowned experts who discuss perforator anatomy and clinical indications for the use of these flaps.