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

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 alpha SMA-stained vessels was 2.93% +/- 1.80%. The diameters of the vessels fell between the 13 and 65 mu m 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.