Elsevier

Clinics in Dermatology

Volume 12, Issue 1, January–March 1994, Pages 89-93
Clinics in Dermatology

Lymphedema and wound healing

https://doi.org/10.1016/0738-081X(94)90260-7Get rights and content

Abstract

The lymphatic system is a widespread vascular network that plays a vital role in homeostasis of the extracellular space. The role of the lymphatics is often neglected and the aim of this article is to emphasize the important contribution the lymphatics make to maintenance of cell equilibrium and normal wound healing. The most important role of the lymphatics is the control of the interstitial microcirculation. The lymphatic vessels remove from the extravascular space macromolecules and particulate matter too large to reenter the blood capillaries. If these materials are not removed, the osmotic and hydrostatic forces within the tissues change and disease results. Failure of the lymphatics leads to pollution of the tissues because of the excesses of protein, other macromolecules, and fluid around the cells. The lymphatics are the pathway for exit of T lymphocytes and Langerhans cells. The immunologic processes that occur in the skin need the lymphatic system to function. Macrophages and Langerhans cells leaving the skin travel in the lymphatics to lymph nodes where they are recognized and induce an immunologic response. Contact dermatitis cannot develop without the lymphatics, as cellular immunity cannot develop without lymphatics directing antigen from the skin to the lymph node. Patients with lymphedema are prone to develop secondary infection as the lymphatics are the normal pathway for clearance of bacteria from the interstitium.

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