Abstract:

Background:

The incidence of abdominoplasty, liposuction for the native population as well as part of medical tourism is a surge in India. India ranks 4th position concerning with center for body contouring surgeries. This probes the anatomist and surgeon for meta analyzing the anatomy of the anterior abdominal wall. Though routinely for undergraduates it was tutored as two layers of anterior abdominal wall, controversy regarding the existence and extent prevail. Literature search shows preservation of scarpa’s fascia is the key determinant in better outcome of abdominal surgeries. So the present study was designed to document the existence and extent of the membraneous fascia of Scarpa (MFS) and to compare the abdominal fat between age and sex-matched CT images.

Objective:

To study the extent of Scarpa’s fascia of the anterior abdominal wall at 3 levels i) At the level of L1 vertebrae ii) At the level of umbilicus iii) At the level of the anterior superior iliac spine and to compare the distribution of abdominal fat among age and sex-matched cohorts among 30 age and sex-matched CT images.

Result:

In all the 60 images, membranous fascia of Scarpa (MFS) was observed with 93.3% of males and 76.7% of females at the level Level1, 53.3% of males and 66.7% of females at Level 2,70% of males, and 63.3% of females at Level 3 had single layer. This supported the presence of MFS on the entire anterior abdominal wall. 8 different pattern of MFS was observed. The anterior abdominal wall showed 3 layers of superficial fascia, with superficial fatty, MFS, and deep fatty zone. The superficial fat was significantly high among females at all the three levels, though the deep was high among females at all the three-level, it was significantly high only at the level 1and 2 among subgroup 1 (comprising the images of women, of age group 21-30 years) and level1 of subgroup 3 (comprising the images of women, of age group 51-60 years).

Conclusion:

MFS was present all along the abdominal wall, the superficial layer of the abdomen showed 3 layer concept, superficial fatty, MFS, and deep fatty zone. Depending upon the distribution of fat, 8 different patterns of MFS were observed. The superficial fat was significantly high among females, supporting that gender to be high risk for surgical intervention. Better anatomy of the anterior abdominal wall would influence and guide better techniques in surgical interventions.