Posttraumatic lymphedema

What is posttraumatic lymphatic edema

Lymphedema in clinical traumatology is due to impaired integrity and ability to function of the circulatory lymphatic system, in case of spontaneous, accidental tissue and/or bone destruction.

What are the causes of post-traumatic edema

The condition occurs when we suffer accidents such as contusions, dislocations, bone fractures, deep burns that include a large body surface, but also following a functional overload (intense, prolonged physical exertion). In these situations, the edema does not always appear immediately after the traumatic injury, but can occur even later in the recovery due to the prolonged immobilization that favors the lymphatic stasis.

The factors that lead to fractures affect not only the bone tissue, but also the adjacent soft tissues such as muscles, ligaments, vascular structures, nerves and last but not least the lymphatic vessels that can no longer perform their proper drainage function. Post-traumatic edema occurs as a result of direct damage to the lymphatic circulatory system (open fractures, comminuted fractures - a form of fracture in which the bone is crushed in several places, deep lacerations, traumatic avulsions from car accidents or animal bites). Also, it may be due to the stasis that occurs during the plaster immobilization of the affected limb (the “pump” function disappears from the muscular contraction with the decrease of the lymphatic flow).

In the case of deep burns - IV degree, the oedema is due to the deep destruction of the skin and subcutaneous tissue with the involvement of the fascia, the muscles as well as the blood vessels and the lymphatics that serve them.

Intense physical effort, for long periods by performance athletes (cyclists, marathon runners) cause muscle microtrauma affecting the lymphatic circulatory system, especially in the lower limbs resulting in secondary edema.

Symptoms of posttraumatic lymphatic oedema

The most common clinical manifestations are edema or persistent swelling at the site of the trauma (which may spread later) and do not subside in the days following the event. Sometimes are accompanied by pain and functional impotence. Symptoms may worsen with expansion and increase in the volume of the edema if it is not properly intervened to resume the lymphatic flow.

Treatment of post-traumatic edema

In the treatment of post-traumatic lymphedema, the manual lymphatic drainage technique is successfully used, as well as the restraint with the help of socks or compressive bandages, depending on the affected segment (after removing the plaster cast in case of fractures).

The temporary lymphatic bandaging technique (with adhesive tapes placed along the lymphatic venous pathways) is also indicated, which reduces post-traumatic swelling, prevents fibrosis complications and reduces pain and discomfort secondary to increased tissue pressure.