In Vivo Analysis of the Superficial and Deep Fascia

Area of Science:

• Anatomy
• Surgical Science
• Medical Imaging

Background:

• Superficial fascia anatomy is poorly understood, hindering optimal surgical techniques.
• High-tension wounds, fat necrosis, and dead space are key risks for hypertrophic scarring and surgical-site infections.
• Appropriate superficial fascia suturing can prevent these complications.

Purpose of the Study:

• To delineate the anatomy of the superficial fascia.
• To quantify the superficial fascia throughout the human body in vivo.
• To provide data for optimizing surgical approaches to reduce complications.

Main Methods:

• Ultrasound imaging was used to analyze superficial and deep fascia in 10 volunteers.
• Measurements were taken at 73 points across 11 body regions.
• Quantified were fascia layer number, thickness, and percentage, alongside deep fascia and dermis thickness.

Main Results:

• Significant variations in subcutaneous variables were observed across body regions.
• The posterior chest exhibited the thickest deep fascia and dermis, and highest average superficial fascia layer thickness.
• The anterior chest had the most superficial fascia layers, while the abdomen and gluteus had a low percentage.

Conclusions:

• Superficial fascia, deep fascia, and dermis are generally thicker in high-tension areas like the upper trunk.
• A site-specific surgical approach for subcutaneous sutures is recommended.
• Understanding fascia distribution aids in optimizing suturing to reduce surgical-site infections and hypertrophic scars.