The saphenous venous compartments

The relationships between the connective framework of the lower extremity h ypodermis and the saphenous veins was studied by dissection, stereomicrosco py, ultrasonography and histology in 64 lower limbs. A fibroelastic lamina was evidenced in the hypodermis of the medial aspect of the thigh and leg a nd in the back face of the leg. This lamina, together with the underlying m uscular fascia, fixed the boundaries of two compartments occupied by the sa phenous veins and nerves. The adventitia of the saphenous veins was connect ed to the compartment walls by thick connective strands. The saphenous vein s ran deeply in the hypodermis, closely ensheathed by a fibroelastic sleeve . As a consequence, they could no longer be considered as a truly superfici al vein. This term seems to be appropriate only for their tributaries, whic h ran in a more superficial plane just below the dermis. The role of the sa phenous vessels in blood return from the lower limbs may be greater than cl assically accepted. In fact, due to their close fascial ensheathing and adv entitial anchoring, muscular contractions may enhance blood flow within the se vessels as occurs in the intermuscular veins. Finally, dilative patholog y of the saphenous vein may be resisted by the membranous lamina as a sort of a fibroelastic shield.