Abstract
In order to appreciate the relationship of lymphedema to wound healing, a review
of the pathophysiology of chronic venous insufficiency and venous stasis ulceration is helpful. Chronic venous insufficiency leads to venous hypertension, which
results in a high filtration pressure causing increased fluid to appear in the tissues,
i.e., increased lymphatic water load. When the lymphatic transport capacity is
exceeded by the waterload, initially a state of low protein edema occurs as a
result of this dynamic failure. Constant lymphatic hypertension causes infiltration
of lymph into the perilymphatic tissue resulting in fibrosclerosis and lymphangitis.
Protein permeability increases and lymphatic damage follows. Subsequently, lymphedema (high protein edema) becomes the underlying pathology that contributes
to the formation of venous stasis ulcers.