Abstract
Pathophysiology of lymphedema with respect to surgery has to respect two major components: the lymphatic fluid and the secondary tissue reaction on accumulated lymph.
Two main variables influence the lymphatic fluid content.
This is on one side the amount of fluid which accumulates within a given part of the body, e.g., an extremity per time unit, and has to be cleared by the lymphatic vascular system. This is addressed as the lymphatic load (LL). It depends on the amount of tissue of the extremity, the influx from the capillaries, and possible inflammatory reactions.
On the other side, it is the amount of lymphatic fluid which can be mustered by the lymphatic vascular system per time unit, e.g., within an extremity. It is dependent on the number and function of lymphatic vessels and lymph nodes. This is called the lymphatic transport capacity (LTC). Secondary tissue changes occur due to the accumulation of the lymphatic fluid. This consists within the subcutaneous tissue of accumulated fibrous and adipose tissue.
Surgery should correct the deficiency of lymphatic transport first and the secondary tissue changes thereafter, if necessary.
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Baumeister, R.G.H. (2017). Pathophysiology of Lymphedemas with Respect to Surgery. In: Reconstructive Lymph Vascular Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-31647-5_1
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DOI: https://doi.org/10.1007/978-3-319-31647-5_1
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