Muscle perforator flaps have become an important resource for the creation of cutaneous flaps based on musculocutaneous perforators, but without inclusion of the involved muscle. As a chimeric flap with or without the muscle, the cutaneous perforator flap can specifically serve as a sentinel or monitoring flap to allow the early detection of anastomotic compromise involving the common source vessel, without the need for direct observation of the major free-flap component. This can be a valuable adjunctive use of muscle perforator flaps for the continuous assessment of free muscle flaps or as an exteriorized flap for the monitoring of buried free flaps.