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By Jose Maria Pereira de Godoy & Maria de Fatima Guerreiro Godoy

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Benzopyrones are drugs that can reduce protein-rich edema by increasing tissue proteolytic activity. Flavonoids like diosmine, rutine, hesperidine are examples of these drugs. 32 Lymphatic drainage is indicated in nearly all types of lymphedema. In summary, the association of these measures propitiates a better result in the treatment of these patients. 33 MANUAL LYMPHATIC DRAINAGE Manual lymphatic drainage is one of the pillars of the complex physical therapy proposed by Földi, and known as the Földi method.

In this region, greatest care should be taken during lymphatic drainage. The supraclavicular fossa is the place of greatest proximity to the thoracic and right lymphatic ducts; therefore, it is the site at which drainage should be started, unless there exists an indication to the contrary. All lymphatic trunks lead towards the lymphatic ducts that drain into the venous system, at the junction of the subclavian and jugular veins. At the cervical region, the superficial cervical lymph nodes follow the trajectory of the external jugular vein over the sternocleidomastoid muscle, and drain into the lymph nodes of the deep cervical chain.

Other causes are paralysis and vessel spasm, hampering collector contraction. These alterations occur in primary lymphedema. In secondary lymphedema, the initially intact lymphatic system is destroyed, as for example in surgery (lymph node emptying), filariasis and trauma. Mechanical lymphedema occurs in these cases. Such infirm tisssues, rich in proteins are propitious for the installation of infection, as by streptoccoci, which will further lesion vessels decreasing functional reserves. These patients should be evaluated by a specialist, to identify the type of lesion and the best therapeutic approach to be used.

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A New Approach to Manual Lymphatic Drainage by Jose Maria Pereira de Godoy & Maria de Fatima Guerreiro Godoy

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