Skip to main content

Autologous Fascia Lata

Autologous fascia lata — harvested from the lateral thigh (the iliotibial tract / tensor fasciae latae) — is an alternative biological sling source when rectus fascia is unavailable, insufficient, or contraindicated.

Rationale for Choosing Fascia Lata Over Rectus​

  • Longer strip available (10–15 cm+) — useful in complex reconstruction or when multiple passes are needed
  • Prior abdominal surgery or hernia repair that compromises rectus fascia
  • Obese patient where rectus exposure is difficult
  • Pediatric patients where rectus harvest in small anatomy is challenging

Harvest Technique​

  • Lateral thigh longitudinal incision over the iliotibial tract
  • Expose the iliotibial band
  • Harvest a strip 10–15 cm long × 2 cm wide
  • Close the fascial defect primarily (some surgeons leave open in small harvests)
  • Skin closure; compression dressing

Trade-offs vs Rectus​

  • Separate incision in a cosmetically visible area (lateral thigh)
  • Donor-site morbidity — transient thigh pain, rare hematoma, rare compartment-syndrome risk
  • Not in the same field as the pelvic operation — requires repositioning or a second sterile prep
  • Equivalent long-term sling outcomes to rectus fascia

Evidence​

Fascia lata slings have established equivalent durability to rectus-fascia slings in multiple series. Selection is based on patient-specific considerations rather than outcome differences.

See also: Rectus Fascia.