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

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At the level of the fold of the elbow occurs The transition between the forarm and arm 54 Proceed with the drainage of the upper limb by draining the anterior radial, and anterior ulnar currents of the forearm. In this illustration I emphasize the drainage of the cephalic current, which may be maintained during mastectomy. In this maneuver the posterior and postero-lateral currents may be drained. 55 The drainage of the hand and dorsal part of the forearm (radial and posterior ulnar currents) are made in the ascending anterior direction.

The persistence of lymphedema propitiates the degeneration of the walls of the lymphatic collectors, leading to loss of motility, further aggravating lymph stasis. Lymphangiosarcoma, Stewart Treves’s Disease, may occur in lymphedema of long standing. According to Casley-Smith the main structural causes of lymphedema are as follows: a - narrow or abnormally scanty tissue channels; b - abnormally scanty initial lymphatics; 31 c - incompetence if the initial valve system; d - separation of the fixation bands of the lymphatics; e - hypoplasia and obstruction of the collectors.

In this way, lymph reaches the lymphatic declines through which it is drained. For this reason, it is indispensable to know the anatomy of the lymphatic ways. Health professionals exert an extremely important function for lymphatic patients. However, any solitary action on part of the professional should be considered illegitimate, because the doctor is absolutely responsible for all and each of the therapeutic steps performed. Other secondary effects caused by the drainage are: a)an action on the vegetative nervous system producing parasympathetic stimulation leading to relaxation; b)a sedative action of algic reflexes; c)an action on ganglia with immunological effects.

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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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