[libribook.com] Traumatic Scar Tissue Management 1st Edition

Lymphatic Drainage and Transport
In order to better facilitate understanding of the next section, the following key
terms, concepts and mechanisms are briefly described:
• Lymphatic drainage: the movement of fluid and molecules (e.g. proteins) from
the interstitium into the lymphatic capillaries.
• Lymphatic transport: the movement of lymph along a succession of vessels with
eventual return to the blood vascular system (lymphatic return).
• Lymphatic load: the term ‘lymphatic load’ was coined by renowned
lymphologists, Drs Michael and Etelka Földi. Lymphatic load refers to total
sum of substances (proteins, colloids, minerals, water, cells and fat) in the
interstitium that cannot be absorbed by the hematic system (Földi et al. 1989).
• Protein: within a 24-hour period, at least half of the proteins in the blood will
leave the capillaries and make a home in the interstitial spaces (Zuther
2011).These proteins provide cell nutrition, immune defense, transportation of
hormones, fats, minerals and waste products, and coagulate the blood.
Proteins are generally too large to reenter the bloodstream through the blood
capillaries. Through intercellular openings in the capillaries of the lymph
node, large protein molecules can be ‘taken-up’ or collected.
• Fluid/water: approximately 10–20% of the water that leaves the blood capillary
system makes up the water in the lymphatic load. It is returned to the blood
system through the thoracic duct, the right lymphatic duct and venous angles.
It is estimated that 2–3 liters is recirculated per day (Zuther 2011). The blood
capillaries in the node reabsorb most of the remaining fluid. This action
reduces the lymphatic load returning through the thoracic duct and the right
lymphatic duct into the venous system.
• White and red blood cells (WBC, RBC): by continuously leaving the blood
capillaries, WBCs and RBCs are absorbed by the lymphatic system. When the
lymphocytes are circulated back into the bloodstream it results in an important
immune response in the body. The lymphatic system also transports cell
fractions (debris) that can be caused by trauma or tissue neoformation
(regeneration). Bacteria and cancer cells are also carried through the