Scarpa’s Fascia

Scarpa’s fascia is the deep membranous layer of the superficial fascia of the lower anterior abdominal wall. It lies beneath Camper’s fascia and provides structural reinforcement just superficial to the abdominal muscles. Though it appears as a thin, translucent sheet, Scarpa’s fascia is functionally important in restricting fluid spread, supporting surgical closures, and forming connections to other fascial layers in the pelvis and perineum. It is most prominent below the umbilicus and plays a critical role in both surgical anatomy and clinical pathologies such as fluid extravasation and fascial plane infections.

Structure

Scarpa’s fascia is a dense connective tissue layer composed of collagen and elastin fibers. While it is often indistinct in the upper abdominal wall, it becomes more defined and separates from Camper’s fascia in the lower abdominal region.

Composition

• Primarily dense fibrous connective tissue
• Contains minimal fat compared to Camper’s fascia
• Anchors dermis via vertical collagenous fibers

Appearance

Scarpa’s fascia appears as a glistening, whitish layer during surgical dissection and provides a plane of separation from underlying musculature and aponeuroses.

Location and Layer Relationships

Scarpa’s fascia is part of the superficial fascia but is deeper than Camper’s fascia. It is best visualized below the level of the umbilicus.

Layer	Relation to Scarpa’s Fascia
Skin	Superficial
Camper’s fascia	Superficial (above Scarpa’s)
External oblique aponeurosis	Deep
Muscles of the abdominal wall	Deep

Scarpa’s fascia fades superiorly and is indistinguishable from Camper’s fascia in the upper abdomen. However, below the umbilicus, it thickens and forms a distinct surgical layer.

Continuations in Adjacent Regions

Scarpa’s fascia continues into several other named fascial structures in the lower body:

• Colles’ fascia: Continues into the perineum as the superficial perineal fascia.
• Dartos fascia: In males, Scarpa’s fascia continues into the scrotum as a membranous fascia fused with smooth muscle.
• Penis/labia majora: Contributes to the superficial fascia of the penis and labia majora.
• Thigh: Fuses with the fascia lata just below the inguinal ligament, preventing downward fluid spread.

Function

Scarpa’s fascia is structurally important despite its thin appearance. Its functions include:

• Reinforcement: Provides a tough barrier that supports surgical closure and wound strength.
• Compartmentalization: Helps restrict spread of infections, fluid, or hematoma between planes.
• Attachment plane: Offers an anchor point for sutures and soft tissue reconstruction.

While not contractile or involved in movement, its biomechanical role in anchoring the abdominal wall layers is significant during surgical repair.

Clinical Significance

Surgical Landmark

• Often encountered in lower abdominal incisions, such as Pfannenstiel incisions for C-sections or hernia repairs.
• Used for layered closure to minimize dehiscence and improve healing outcomes.

Fluid Extravasation

• If the urethra is injured (e.g., during catheterization), urine can accumulate in the space between Scarpa’s fascia and the muscle layers.
• This fluid cannot pass into the thigh due to Scarpa’s fusion with the fascia lata but can spread into the perineum and scrotum.

Hematoma Containment

• Subfascial hematomas are sometimes limited to the plane between Scarpa’s fascia and the muscle, allowing for predictable imaging and drainage.

Liposuction and Cosmetic Surgery

• Surgical sculpting often targets the plane between Camper’s and Scarpa’s fascia to remove fat while preserving structural fascia.

Blood and Nerve Supply

Scarpa’s fascia itself receives vascular and nerve supply indirectly from the structures that supply the skin and abdominal wall muscles:

Arterial Supply

• Superficial epigastric artery
• Inferior epigastric artery (via perforators)
• Intercostal and lumbar segmental arteries

Nerve Supply

• Cutaneous branches of thoracoabdominal nerves (T7–T12)
• Iliohypogastric and ilioinguinal nerves (L1)

Embryological Development

Scarpa’s fascia arises from mesodermal connective tissue derived from the somatic layer of lateral plate mesoderm. Its development is closely tied to the dermis and superficial structures of the abdominal wall. The separation into Camper’s and Scarpa’s layers occurs during late fetal development, with Scarpa’s being more pronounced in the lower abdomen.

Comparison with Camper’s Fascia

Feature	Scarpa’s Fascia	Camper’s Fascia
Composition	Dense, fibrous connective tissue	Fatty connective tissue
Thickness	Thin but consistent below umbilicus	Highly variable, depending on fat
Clinical role	Surgical anchoring, fluid containment	Primarily cushioning and insulation
Continues as	Colles’, Dartos, superficial penile fascia	Superficial fat of genitals and thigh
Presence above umbilicus	Indistinct or absent	Still present but merged with fat