Abstract The regional edema that often follows the onset of acute thrombophlebitis of an extremity is the expression of inadequate fluid drainage, and it would appear that the occlusion of the inflamed veins by thrombi is a major factor in the causation of the edema. Several investigators have demonstrated that the surgical occlusion by ligature of the major veins draining a limb does not always result in the formation of edema, and that when edema occurs, it is often minimal and of short duration (Ranvier, Roger, Leriche, Young, and others).1,2 It has also been demonstrated that when the major venous channels of a limb are occluded, much of the drainage from the limb is taken over by the lymphatic system. Emminghaus in 1889 demonstrated that inflation of a cuff at the base of a limb, obstructing the venous return, resulted in a marked increase in the lymph drainage from the References 1. Fontaine, R., and Pereira, S.: Oblitérations et résections veineuses expérimentales: Contribution à l'étude de la circulation collatérale veineuse , Rev. Chir. 75:161-200, 1937. 2. Leriche, R., and Jung, A.: Recherches expérimentales sur les oedèmes chirurgicaux des membres d'origine phlebitique , J. Chir. (Par.) 37:481-495, 1931. 3. White, J. C.; Field, M. E., and Drinker, C. K.: On the Protein Content and Normal Flow of Lymph from the Foot of the Dog , Amer. J. Physiol. 103: 34-44, 1933. 4. Homans, J.: Thrombophlebitis of the Lower Extremities , Ann. Surg. 87:641-651, 1928.Crossref 5. Homans, J., and Zollinger, R.: Experimental Thrombophlebitis and Lymphatic Obstruction of the Lower Limb , Arch. Surg. 18:992-997, 1929.Crossref 6. Teneff, S., and De Lutio, O.: Comportamento del sistema linfatico nella tromboflebite sperimentale , Arch. Ital. Chir. 76:163-176, 1954. 7. Fonda, G.; Pasquero, P. M., and Proscia, N.: Influenza delle condizioni funzionali della rete linfatica regionale sulla evoluzione del quadro fisiopatologico da occlusione venosa , Minerva Cardioangiol. 5:279-289, 1957. 8. Tosatti, E.: I linfatici ed i linfedemi degli arti inferiori , Minerva Cardioangiol. 6:49-68, 1958. 9. Jacobsson, S., and Johansson, S.: Lymphographic Changes in Lower Limbs with Varicose Veins , Acta Chir. Scand. 117:346-350, 1959. 10. Battezzati, M.; Tagliaferro, A.; Donini, I., and Rossi, L.: Modificazioni morfofunzionali dei collettori linfatici dell'arto inferiore nella sindrome postflebitica , Minerva Chir. 14:1209-1214, 1959. 11. Mayall, R. C.: Lymphography in Postphlebitic Syndrome , J. Cardiovasc. Surg. 1:176-179, 1960. 12. Menkin, V.: Biochemical Mechanism in Inflammation , Springfield, Ill., Charles C Thomas, Publisher, 1956, p. 111
Archives of Surgery – American Medical Association
Published: Jan 1, 1963
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