Difficulty in healing chronic wounds is often associated with regional or localized edema. Excess edema reduces that amount of nutrients that get transported to the damaged area and reduces the rate at which wastes and dead cell particles are removed from the region. Manual Lymphatic Drainage (MLD) and Combined Decongestive Therapy (CDT) have been found to be an effective treatment for accelerating healing of chronic wounds.
MLD increases lymphatic flow to up to 10 times normal levels during a session tapering off to normal levels after approximately 24 – 36 hours. This accelerated lymph flow reduces regional and local edema thereby increasing the rate of healing.
With a reduction of edema in the area healing can accelerate as the time required to move nutrients and wastes to and from live cells is decreased. This effect is due to the fact that in order for waste or nutrients to cross an interstitial area time equals distance squared (T=d2). For illustrative purposes this means that if it normally takes 4 seconds for a nutrient to cross a 2 cm distance it will take 16 seconds to cross a 4 cm distance.
It stands to reason that less edema means less distance resulting in a significant reduction in time to provide nutrients and remove waste from cells. Obviously, increased waste and reduced nutrients create an unhealthy environment leading to increased potential infections, cellular damage and diminished healing time.
Using this approach a leading wound treatment center at Providence Hospital Northeast in South Carolina reports healing rates well above national averages in the United States particularly with respect to venous leg and diabetic foot ulcers. They note, “Although we provide treatment for all types of wounds, we report outstanding healing rates for venous leg ulcers and diabetic foot ulcers. In 2008, when compared to over 1,000-outpatient wound care centers, we report:
- 98.7% of our venous leg ulcers healed within 50 days with the national reported healing average being 46% within 69 days.
- 94% of our diabetic foot ulcers healed within 67 days with the national average being 81% in 86 days.
- Patient satisfaction scores in the 99th percentile.
- A unique part of our program includes lymphedema therapy.
InStep Physical Therapy Centre for Lymphatic & Massage Therapy in Edmonton, AB offers services that reduce lymphedema and can thereby improve the healing time for chronic wounds in much the same way as Providence Hospital Northeast in South Carolina. While InStep Physical Therapy Centre does not provide wound care specifically we do provide lymphatic therapy as an adjunct treatment for wound care in combination with other healthcare providers.
Lymphedema therapy is gaining sufficient interest that Grant MacEwan University Wound Care Program now recognizes InStep Physical Therapy Centre’s approach to lymphedema and the role that plays in wound care.
InStep Physical Therapy Centre is also pleased to announce that we have accepted an invitation from Grant MacEwan University to be a Clinical Practicum site for the only Post Graduate Wound Care Program in Canada. Nurses, Physical Therapists and Occupational Therapists involved in the program began observing InStep Physical Therapy Centre’ lymphedema treatment protocols in June, 2012.
Absolute & Relative Contra-Indications
Contra-indications are conditions or factors that serve as a reason to withhold a certain medical treatment. Due to the effectiveness of Manual Lymphatic Drainage (MLD) in accelerating lymph flow there are a number of health concerns that do not allow individuals to receive MLD. If you are experiencing any of the following situations please discuss these with a therapist prior to receiving any treatment:
- Untreated Malignant Diseases
- Acute Inflammations
- Recent Thrombosis
- Cardiac Insufficiency
- Renal Failure