Existence and Distribution of the Membranous Layer of Superficial
Fascia in the Human Body
Marwan F. Abu–Hijleh, MD, PhD, MHPE
Professor and Chair, Department of Anatomy, College of Medicine and Medical Sciences,
Arabian Gulf University, Manama, P.O. Box 22979, Kingdom of Bahrain.
Phone: 0097317239844 Fax: 0097317271090 Email: marwanah@agu.edu.bh
BACKGROUND A discrete membranous layer "stratum membranosum", in human subcutaneous tissue is
classically described as confined to the lower anterior abdominal wall and perineum and referred to as
Scarpa's and Colles' fasciae, respectively. Evidence for its existence elsewhere in the body is scanty and
therefore the present study was undertaken.
METHODS Dissection of six embalmed adult cadavers (3 male and 3 female), along with ultrasound
imaging on four living subjects (2 male and 2 female), were carried out to determine the existence,
topography, and thickness of the membranous layer of superficial fascia in 10 different regions of the body.
RESULTS In all six cadavers, a continuous layer of fibrous membrane in the superficial fascia was found
consistently in all the dissected regions of the body and was also confirmed by ultrasonography (Figure, A
& B). The arrangement and thickness of this membranous layer varied according to body region, body
surface, and gender. It was thicker in the lower than in the upper extremity, on the posterior than anterior
aspect of the body, and in females than in males. The mean thickness of the membranous layer ranged from
39 to 189 µm, being thickest in the leg and thinnest over the dorsum of the hand. The membranous layer
was observed to have two or even three components in regions such as the breast, back, thigh, and arm and
was seen to split, forming special compartments around subcutaneous major veins of upper and lower
extremities, with fibrous septa extending to anchor the vessel to the compartment wall (Figure, C & D). In
contrast, small tributaries of the major veins were seen to course superficial to the membranous layer in the
subdermal fatty layer, thus lacking fascial wrapping.
CONCLUSIONS The membranous layer of the superficial fascia is not restricted to the lower abdominal
wall and perineum but has a much wider distribution in many regions of the body. Functionally, the
membranous superficial fascia may play a role in the integrity of the skin and support for subcutaneous
structures particularly large veins, by ensuring their patency. Understanding the topographic anatomy of
this fascial layer may help explain subcutaneous tissue deformities and provide the anatomic basis for
surgical correction. Furthermore, the results emphasize the concept of continuity of fascia between different
regions of the body.
(A) Layered dissection of the male breast region (chest
wall). The membranous layer (ml) forms a single
continuous layer in this dissection and the
corresponding ultrasonogram (B) where it is sharply
demarcated from the surrounding hypoechogenic fatty
tissue layer (fl). (C) Layered dissection of the anterior
leg region. Two superficial veins are seen: a tributary
vein (tv) lies superficial to the membranous layer, and
the major (long saphenous) vein (v) is enclosed in a
compartment formed by the muscular fascia (mf)
deeply and by the membranous layer (ml) superficially.
These two fascial layers fuse peripherally delineating a
compartment resembling an “Egyptian eye”-shape
using ultrasonography (D). In (D), the main vein is
anchored to the fibrous wall of its compartment by a
connective tissue lamina (arrow). s, skin; m, muscle.