Surgical anatomy of scarpa's fascia of the anterior abdominal wall and its arterial vasculature

ABSTRACT

The surgical anatomy of the Scarpa's fascia and its blood supply was studied by dissecting fifteen adult cadavers. Six cadavers were injected with red latex through common iliac artery to demonstrate the arterial supply of the fascia. The results of the present dissection revealed that the Scarpa's fascia is a well defined single membranous sheet within subcutaneous tissue layer at the lower part of the anterior abdominal wall. It is thick and well developed inferiorly and thinned out superiorly. Histological study revealed that the Scarpa's fascia is composed of multiple connective tissue vascularized sheets, loosely adherent to one another and it contains abundant elastic tissue. Cadaveric dissections revealed that the arterial supply of the fascia comes from the principle arterial vascular pedicle through the superficial epigastric artery which arises from femoral artery, pierces the Scarpa's fascia and ramifies on the superficial surface of the fascia. This artery has a wide caliber suitable for microvascular free transfer. Additional blood supply to the fascia were found in form of fine perforating blood vessels from the anterior wall of the rectus sheath. Depending on the present results, the Scarpa's fascia is a thin elastic vascular membrane and provides a reliable donor site for free and pedicled flap transfer in plastic surgery