Blood supply to the superficial fascia of the abdomen: An anatomical study

Abstract

The aim of this study was to examine data demonstrating that Scarpa's fascia, a superficial fascia of the anterior abdominal wall, is a vascularized tissue. Specimens of the fascia of seven volunteers undergoing abdominoplasty surgical procedures at the Plastic Surgery Unit of the University of Padova Medical Center were collected. Fractal analysis and quantitative assessment of the vascular network of the fascia was carried out, exploiting the presence of blood in the vessels. Each sample was divided and processed for histological/immunohistochemical analysis (into 5 micron-paraffin embedded sections and cryo-sectioned free-floating samples) as well as for electron microscopy study. A rich vascular pattern forming a fine, dense meshwork with an area percentage of 6.20% ± 2.10% von Willebrand factor stained vessels was noted in all the specimens of the fascia examined; the area percentage of the αSMA-stained vessels was 2.93% ± 1.80%. The diameters of the vessels fell between the 13 and 65 μm range; the network was composed of arteries, veins, capillaries and lymphatic segments. Topological results showed that the vascular network within Scarpa's fascia is well branched (segments: 6615 ± 3070 and 8.40 ± 3.40 per mm 2 ; crossing points: 3092 ± 1490 and 3.40 ± 1.90 per mm 2 ). Fractal analysis (fractal dimension = 1.063 ± 0.10; lacunarity = 0.60 ± 0.10) revealed that this particular vascular network has an optimal spatial distribution and homogeneity occupying the entire space of the superficial fascia. These findings could undoubtedly be useful to plastic surgeons as well as to pain management specialists.

Detection of Lymphatic Vessels in the Superficial Fascia of the Abdomen

“…Below, the SF appeared as a thin fibrous layer ( Figure 1 b), with a membranous appearance and a multilayered structure of collagen bundles. The histological tangential section of the SF layer showed a net of irregularly arranged collagen fibers, interpenetrated by adipose clusters and crossed by a rich vascular pattern ( Figure 1 c), as already demonstrated and described in our previous works [ 23 , 28 ]. Beneath the SF, another layer of adipose tissue was visible—the DAT—with smaller, flatter, and less-defined adipose lobes than those of the SAT ( Figure 1 a).…”

Detection of Mast Cells in Human Superficial Fascia

“…But the SF works also to create a sort of elastic containment for nerves and vessels [35]. Moreover, it shows a rich vascularization [7] and hosts a lymphatic plexus [8], with important implications for reconstructive surgery and pain management of clinical manifestations caused by altered lymphatic transport (like lymphedema) [36][37][38] or circulation problems. Lastly, the SF has a confirmed sensory role thanks to the rich thin innervation supplying the tissue, with ~34% of autonomic nervous fibers [9], which can be influenced by a stress condition or a sudden change in temperature [39].…”

“…In recent years, the involvement of the superficial fascia in numerous regulating and modulating functions has been demonstrated, thanks to the presence of a rich vascular pattern and a huge network of nervous structures that supply this fibrous layer. The vascular network of the Scarpa's fascia is well-branched, with a homogeneous spatial distribution, and it is composed of arteries, veins, capillaries and lymphatic vessels [7], with a percentage of immunoreactive lymphatic structures (IR%) equal to 31.2 ± 14.1% [8]. Moreover, the tissue is pervaded by nerve fiber bundles around blood vessels and adipocytes, but also penetrating the connective tissue itself, with a percentage of autonomic innervation close to 34%, highlighting the role of the superficial fascia in thermoregulation, exteroception and pain modulation [9].…”

From Muscle to the Myofascial Unit: Current Evidence and Future Perspectives

“…From this description it is evident that all the vessels for muscles are completely embedded in the epimysium, perimysium, and endomysium. In addition, Pirri et al, (2022) [61] described the rich vascular pattern of the fasciae, which forms fine, dense meshwork with an area of 6.20% ± 2.10%. The diameters of the vessels fall between 13 and 65 µm.…”