Editing Abdominal Wall (section)

=== Skin and subcutaneous fasciae ===

==== Camper fascia ====
* '''A loose layer of fatty tissue deep to the skin'''
* Varies in thickness with the nutritional status of the patient
* <span style="color:#ff0000">'''Some branches from the femoral vessels'''</span> (superficial circumflex iliac, external pudendal, and superficial inferior epigastric vessels)<span style="color:#ff0000"> '''run in this layer'''</span>
** '''<span style="color:#ff0000">Clinical implication: The superficial inferior epigastric vessels are encountered during inguinal incisions and can cause troublesome bleeding during placement of pelvic laparoscopic ports</span>'''

==== Scarpa fascia ====
* '''Dense collagenous connective tissue layer[https://www.ncbi.nlm.nih.gov/books/NBK553137/]'''
*'''Deep to Camper fascia''' 
*'''Considerably thinner than Camper's fascia[https://www.ncbi.nlm.nih.gov/books/NBK553137/]'''
**although it may be difficult to discern in older patients
* '''<span style="color:#ff0000">Continuous with (5):</span>'''
*# '''Camper fascia superiorly and laterally'''
*# '''Deep fascia of the thigh (fascia lata) laterally''', 1 cm below the inguinal ligament along a line from the anterior superior iliac spine to the pubic tubercle
*# '''<span style="color:#ff0000">Colles fascia of the perineum medially</span>'''
*# '''<span style="color:#ff0000">Dartos fascia of the penis</span>'''
*# '''<span style="color:#ff0000">Dartos smooth muscle of the scrotum</span>'''.
** '''<span style="color:#ff0000">Clinical implication: the continuity of these fasciae can limit both the spread of infection in necrotizing fasciitis of the scrotum (Fournier gangrene), hematoma from injury, and the extent of urinary extravasation in an anterior urethral injury.</span>'''
*** '''<span style="color:#ff0000">Because of these fasciae, bleeding, infection, or urinary extravasation will not extend down the leg or into the buttock but can freely travel up the anterior abdominal wall deep to Scarpa fascia to the clavicles</span>'''§ '''and around the flank to the back. In the perineum, their spread is limited by the fusions of Colles fascia''' to the ischiopubic rami laterally and to the posterior edge of the perineal membrane; '''the resulting hematoma is therefore butterfly shaped.'''
*** '''The external, cremasteric, and internal spermatic fasciae are embryologically distinct from the scrotal and dartos layers and have their own blood and nerve supplies. It is uncommon for them to be involved in the necrotic process in Fournier gangrene; therefore they can be spared. (In practice, all scrotal tissue is debrided to the tunica vaginalisin patients with Fournier gangrene)'''.