The membranous layer of superficial fascia: evidence for its widespread distribution in the body

Abstract

A discrete membranous layer, "stratum membranosum", in human subcutaneous tissue is classically described as confined to the lower anterior abdominal wall and perineum and referred to as Scarpa's and Colles' fasciae, respectively. Evidence for its existence elsewhere in the body is scanty and therefore the present study was undertaken. Dissection of six embalmed adult cadavers, along with ultrasound imaging on four living subjects, were carried out to determine the existence, topography, and thickness of the membranous layer of superficial fascia in different regions of the body. In all six cadavers, a continuous layer of fibrous membrane in the superficial fascia was found consistently in all the dissected regions of the body and was also confirmed by ultrasonography. The arrangement and thickness of this membranous layer varied according to body region, body surface, and gender. It was thicker in the lower than in the upper extremity, on the posterior than anterior aspect of the body, and in females than in males. The mean thickness of the membranous layer ranged from 39 to 189 mum, being thickest in the leg and thinnest over the dorsum of the hand. The membranous layer was observed to have two or even three components in regions such as the breast, back, thigh, and arm and was seen to split, forming special compartments around subcutaneous major veins of upper and lower extremities, with fibrous septa extending to attach to the vessel wall. Functionally, the membranous superficial fascia may play a role in the integrity of the skin and support for subcutaneous structures particularly veins, by ensuring their patency. Understanding the topographic anatomy of this fascial layer may help explain body-contour deformities and provide the anatomic basis for surgical correction.

The Anatomical Course of the Lateral Femoral Cutaneous Nerve with Special Attention to the Anterior Approach to the Hip Joint

“…Markman and Barton studied the anatomy of the subcutaneous fat tissue in the trunk and extremities and confirmed the presence of a membranous layer in the thigh 44 . Others noted that the anatomy of the membranous layer varied with sex, adiposity, and body region 45 and that it was thicker in the lower compared with the upper extremity and on the posterior compared with the anterior aspect of the body 46 . Many anatomical studies have described the LFCN anatomy and its variations in relation to the ASIS, the approach for iliac crest bone harvesting, or the surgical management of meralgia paresthetica [19][20][21][22][23][24][25][26]40 .…”

Subcutaneous Tissue Ultrasonography in Legs with Dependent Edema and Secondary Lymphedema

“…3) In mild edema, a thin EFS is seen along with horizontally or obliquely oriented echogenic lines, i.e., the superficial fascia, in which collagen fibers are running in all directions. Since most of the superficial nerves, arteries, veins, and lymphatics are embedded in this layer, 6) initial accumulation of fluid in this space may be reasonable. The EFS in the sub-dermal area or above the deep (muscular) fascia may be seen in earlier stages of edema, both of which are again horizontally oriented.…”

“…The primary function of the superficial fascia is to encase, support, and shape the fat of certain body regions and to hold the skin onto the underlying tissue. 6) Since it has been reported that the amount and thickness of superficial fascia varies in different parts of the body, 6,10) it is estimated that the compliance of the subcutaneous tissue may be different in the medial and lateral lower leg.…”

Generic 3D Geometrical and Mechanical Modeling of the Skin/Subcutaneous Complex by a Procedural Hybrid Method

“…Although the structure of subcutaneous tissue differs between various regions of the human body, common components have been identified in several anatomical parts. The existence of a generic pattern of organization of the SSC was put forward several years ago [11], then confirmed in recent radiological work [1] at the level of the arms, legs and trunk. Nevertheless, this anatomical finding has never been the basis of a generic modeling of the human SSC.…”