Relevant anatomy
The specific perforator flap is usually named after the perforating artery that supplies the subdermal tissues and skin. In the DIEP flap (based on the Deep Inferior Epigastric Perforator), the perforating artery arises directly from the deeper external iliac artery. It pierces (perforates) the deep fascia and courses either directly or through muscle to supply the overlying abdominal fat tissue and skin