The reliability of any type of surgical flaps depends on the maintenance of an adequate blood circulation [1–4]. The history of skin flaps is a reflection of the study to better understand the anatomy of their vascular supply (Table 1.1). The early random-pattern flaps were constrained by rigorous length-to-width ratios to ensure viability. In 1970, Milton by experimental studies revealed that flap survival was dependent in fact on the intrinsic blood supply, not the strict mathematical length-to-breadth ratio. The axial-pattern flap concept was introduced by McGregor and Jackson in 1972, in their description of the groin flap. In 1970s, musculocutaneous flaps that were introduced by Ger and Orticochea rapidly became popular because of their reliability and wide arcs of rotation. In 1981, Pontén reported concept of fasciocutaneous flaps that greater length-to-width ratios could be achieved in flaps from the lower leg if the deep fascia was included. The anatomical basis for these fasciocutaneous flaps, which relied on the “fascial plexus” between the deep fascia and subdermal plexus, was later described by Haertsch, and Cormack and Lamberty. In 1987, following reappraisal of the early works of Manchot and Salmon, Taylor and Palmer published their work defining the vascular territories of source arteries, which they termed angiosomes.