Das praktische Vorgehen beim postoperativen und posttraumatischen Lymphödem

Abstract

Swelling of the extremities is frequently observed after traumatic lesions and poses differential diagnostic challenges. Causes include seromas, haematomas and thromboses, as well as lymphostatic oedemas, which may become chronic if left untreated. These are characterized by a high percentage of protein and, over the long term, they can lead to considerable impairment and complications such as recurrent erysipelas as a result of fibrotic tissue rearrangement. Usually a clinical diagnosis is made, which presupposes that the symptoms are known. The most important treatment option is complete decongestive therapy, with manual lymphatic drainage and lymphological multicomponent bandaging being applied at least on a daily basis. Surgical intervention is only possible in individual cases. Because their chronic progression can lead to disablement, post-traumatic lymphoedemas are often the subject of assessments in private and statutory accident insurance proceedings. This paper explains the formation mechanism of post-traumatic lymphoedemas and provides an overview of differential diagnostic methods and current treatment recommendations. The authors also touch on insurance-related aspects.

A novel therapy for fracture healing by increasing lymphatic drainage

“…In addition, prompt treatment of pain, widely-regarded as the fifth vital sign, is beneficial for reducing suffering, readmissions and emergency department visits after hospital discharge [ 36 ]. Although many studies have reported on how to eliminate chronic post-traumatic lymphedema [ [37] , [38] , [39] ], the effect of lymphatic drainage on acute post-traumatic hematoma and pain is not clear. With the treatment of anti-PDPN neutralizing antibody, we determined that improving lymphatic drainage reduces acute post-traumatic edema and pain, suggesting that defects in lymphatic drainage plays a key role in the early complications of traumatic fracture.…”