Gabriel Weston 

Mapping the body: fascia

It's the 'clingfilm' that covers all your organs, bones and muscles. But when it goes wrong, it can lead to all kinds of problems, including the dreaded nectrotising fasciitis
  
  

fascia
The fascia (circled) on a hand Photograph: Science Photo Library Photograph: Science Photo Library

Fascia is a fibrous connective tissue which is distributed throughout the body. It is made from dense bundles of collagen, and looks rather like cling-film. It surrounds muscles, organs, bones, nerves and blood vessels and prevents friction, allowing different structures to glide over each other on movement. For surgeons, it is a gift. Dissecting along fascia, known in surgical parlance as "finding the right plane" is a smooth and almost bloodless business. When planes are hard to find, or have been altered by disease, the process of operating becomes messy.

Plantar fasciitis, experienced by one in 10 people, also known as "policeman's heel" because it tends to affect those who walk a lot, occurs when the fascia running along the sole of the foot becomes inflamed. Treatment is with stretching and rest.

Eosinophilic fasciitis is a rare condition in which there is build-up of a type of white blood cell called an eosinophil in the fascia and muscles of the hands, arms, legs and feet causing discomfort, redness and warmth. It is treated with anti-inflammatories and steroids.

But by far the worst condition to involve this connective tissue is the infamous necrotising fasciitis. Infection spreads like wildfire along the fascial planes, and a person may become extremely unwell with significant deep tissue destruction before any dramatic signs appear on the surface of the skin. High-dose intravenous antibiotics are given to anyone suspected of having contracted this devastating infection but, ultimately, the only way of saving someone is with aggressive surgery, sometimes involving amputation.

 

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