SCARPAS FASCIA FLAP - ANATOMIC STUDIES AND CLINICAL-APPLICATION

Fascia and fascia-subcutaneous flaps are thin, pliable, and well-vascu larized tissue with aesthetic and functional advantages, particularly for the extremities and in the head and neck region. Although various donor sites have been used for these flaps, there is an occurrence of unsatisfactory donor-site defects that are often complicated by conspi cuous, widened scars or alopecia. In addition, flap elevation is somet imes prolonged because of the demanding operative procedures as well a s the impossibility of a two-team approach. In this anatomic and clini cal study we present a new fascial flap that results in a minimal dono r-site defect and a short and easy operative procedure. Scarpa's fasci a, which can be used as both a free and a pedicled flap, is a well-def ined single membranous sheet within the subcutaneous tissue layer at t he lower abdominal wall. We studied its distribution, structure, and v ascular supply in 27 fresh cadaver specimens. In addition, computed to mographic (CT) and ultrasound studies were performed in 13 healthy vol unteers and in 3 cadavers before and after injection of diluted contra st material in the superficial epigastric artery. Finally, histologic examinations were done with hematoxylin and eosin or with reticulum an d elastin. Our studies showed that Scarpa's fascia provides a thin, pl iable, and well-vascularized flap pedicled on the superficial epigastr ic artery. After successful application of the Scarpa's fascia flap as a free flap in 3 patients and as a pedicled option in 1 patient, we c an recommend this flap as a valuable tool for the reconstructive surge on.