How a lymphatic absorbs lymph fluid #lymphoedema #ESL
This is a brilliant picture explaining how the microscopic lymphatics in the skin and just under the skin absorb fluid. When I talk to patients, I talk about “open ended tubes, sucking in the lymphatic fluid” – this is simple to understand, but not quite correct. If this were the case, then when the lymphatic contracts, it would simply push the fluid back out of the tube, and everyone would have lymphoedema. This picture shows an intricate valve system in the wall of the lymphatic – fluid goes in via the red arrow space, travels within the wall, and gets into the lumen (the hole in the centre of the tube) near the blue arrow. This means that when the lymphatic contracts, this space within the wall closes down, and fluid can’t leak back out.
In secondary lymphoedema, this one-way valve system goes wrong because of increased pressure inside the lymphatic. For me, the only logical way to correct this is to give the lymphatic a low-pressure outlet, which is what microsurgery for lymphoedema does. Look out for a future post on microsurgery.
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