Subpapillary (superficial) vascular plexus
Papillary dermis · Capillary loops Blanching Stage 1 pressure injury
Horizontal arteriolar and venular network at the papillary-reticular border, fed by ascending arterioles from the deep plexus, that sends a capillary loop into every dermal papilla. Whether pressing on skin empties it is the whole basis of the blanching test.
Traced from the start
- Stratum basale (germinativum)
- Lamina densa (type IV collagen basement membrane)
- Subpapillary (superficial) vascular plexus
Detail
- Supply
- Ascending vessels from the deep dermal plexus; drains to a subpapillary venous plexus
- Blanching
- Erythema that blanches is blood inside these vessels; erythema that does not blanch means blood has extravasated or the microcirculation is fixed and damaged
- Capillary refill
- Refill after emptying this plexus should be under 2 seconds; prolongation is an early sign of hypovolaemia and of burn depth
When it goes wrong
Meningococcal or other septicaemia with extravasation of red cells
Non-blanching petechiae and purpura, which do not fade under a glass slide — an indication for immediate parenteral benzylpenicillin or ceftriaxone
Sustained pressure damaging the microcirculation over a bony prominence
Stage 1 pressure injury: non-blanchable erythema of intact skin, the earliest reversible stage
Practise this structure
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