Traumatic Edema and Complete Decongestive Therapy

Acute inflammation occurs following trauma to an area of the body, such as after a fracture, surgical procedure, or localized injury. It is a response that results in a decrease in overall function, redness, pain, heat, and swelling. Traumatic edema does not occur if the lymphatic system can compensate for the increase in lymphatic load. Traumatic edema does not occur because of injury or malformation of the lymphatic system.

 

Lymphedema results when protein rich fluid accumulates in the interstitial spaces due to injury or malformation of the lymphatic system. Edema is a fluid accumulation that is not protein rich. The swelling that occurs due to local trauma is made up of high protein fluid, which is similar to lymphedema. Therefore, the treatment of traumatic edema is very similar to that of lymphedema.

 

Effects of traumatic edema:

• Lack of oxygen and nutrients to the traumatized area
• Decreased transport of macrophages to the traumatized area
• Decreased transport of basic substances needed for tissue healing
• Irritation of nociceptors (pain receptors)
• Increased scar formation

 

Injuries/ conditions that result in traumatic edema, which would benefit from Manual Lymph Drainage and Compression:

• Hematoma (use ice in addition to MLD)
• Post surgical incision areas (not directly over the incision; begins no sooner than 24 hours after surgery and must proceed with caution)
• Blunt trauma
• Open wounds (can decrease recovery time by half)
• Rheumatoid Arthritis

 

With the previously listed conditions Manual Lymph Drainage Techniques can be used to decreased swelling, which will result in an increase in range of motion, decrease in pain with movement (due to the pain gate control theory), increased speed of recovery, increased oxygen/ nutrient supply to the injured area, and decrease in adhesive scar formation and keloiding.

 

Manual Lymph Drainage (requires the skills of a Certified Lymphedema Therapist-CLT):

Via 5 different types of superficial, manual strokes the following effects may occur:

• Improves the activity of lymph vessels
• Allows CLTs to re-route the lymph flow around blocked areas into more centrally located healthy areas
  • Creates a suction effect on distal lymph collectors
• Increases local sympathetic response
• Increase general parasympathetic effects
• Increases lymph production
• Stimulates lymphangiomotoricity (the speed at which lymph vessels/ valves contract resulting in speed of lymphatic fluid flow)
• Fibronolytic effect
• Increase in venous return
• Analgesic effect via the pain gate pathway phenomenon
  • Promotes pain control

Joachim Zuther, Marina Maduro, Kirat Shah. “Course Manual”. Academy of Lymphatic Studies. Richmond, Virginia. 22 March 2015. Lecture.