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

Clinical Consideration
Compression bandages promote reduction in capillary hypertension and
lymphatic load – creating a massaging effect to influence venous and
lymphatic hemodynamics resulting in reduction of edema (Földi et al.
2005, Williams 2005).
There are three types of inadequacies which may result in lymphedema or
edema: dynamic, mechanical and combined (Zuther 2011).
Dynamic
Dynamic inadequacy occurs when the active and passive edema protective
measures are depleted and results in edema.
Mechanical
Mechanical inadequacy occurs when the transport capacity of the lymphatic load
slows due to functional or organic causes, such as surgery, radiation, and trauma,
or to a response from certain drugs or toxins. Due to the pressure exerted and
leakage of proteins into the lymphatic wall structure, fibrosis may occur.
The stagnation of water, proteins, waste products and cell debris in the tissue can
cause damage to the tissue. It also reduces the ability of the immune response
due to the lack of circulation of the macrophages and lymphocytes. This can lead
to a high incidence of infections such as cellulitis (Zuther 2011).
Combined
Combined inadequacy results from the lymphatic load being slowed due to the
stagnation of the transport capacity. In other words, the system is very sluggish
and not moving the fluid at a normal rate. When this occurs, the combination can
lead to necrosis (severe tissue damage) and chronic inflammation (Zuther 2011).