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OBJECTIVE: To discuss the postoperative observing main points of the free perforator flap with vascular crisis, and to look for the most appropriate rescue methods for the crisis flap which consist of the second look surgery and the conservative treatment.METHODS: Between April 2006and December 2011, 137 free perforator flaps were transferred to reconstruct the limb soft tissue defect.11 flaps of them appeared vascular crisis postoperatively which made of the massive bleeding, partial purpling, excessive swelling, many bubble emerging and capillary reflux disappearing of the flap.5 flaps were salvaged with conservative managements which including acupuncture bloodletting, partial stitches releasing,and repeated fresh dress changing for the flap.Else 6 flaps were performed the second look surgery, and 2 were found the venous thrombosis in the anastomotic stoma, 3 were found the veins of the pedicle oppressed by the surrounding tissues because of the distorted vessel pedicle,and the remaining one was found the artery thrombosis in the anastomotic stoma.RESULTS: 6 flaps salvaged with second look surgery were all survived finally.3 of 5 flaps rescued with conservative methods succeed surviving ultimately, and else 2 was partial necrosis.CONCLUSION: The survival of free perforator flaps was majority affected by the venous backflow.Emergency exploration was crucial for the survival of the flap in the case of circulatory crisis.