It occurs in severe cases of lymphostasis in which lymphatic back flow is often present in the superficial skin layers up to the derma.

Dermal Back Flow at the level of the medial thigh portion (in a III stage secondary lymphedema).


Dermal Back Flow involving the entire left lower limb in a patient affected by secondary lymphedema of both lower extremities.

Dermal Reflux (as shown by lymphoscintigraphy) more evident on the left side, in a secondary lymphedema of the lower limbs.


Synthetic polymer of glucose, with a molecular weight of 40,000 or 70,000 daltons. The smallest 40,000 dalton molecules have an “anti-sludge” effect, which promotes microcirculation. For this reason, it is often used in microsurgery to prevent microthrombotic events of anastomoses. Since it may trigger anaphylactic reactions, initially it must be administered slowly, under careful patient monitoring.


The most active substance in the gamma-benzopyrone or flavonoid family, on the veins, the lymphatic system, and microcirculation. It is contained in the flavedo of citrus fruits (found in the peel of lemons, oranges, mandarins, and other citrus fruits), or it can also be obtained by partial chemical synthesis.


Literally, those drugs that can increase diuresis – namely the secreted daily urine volume – are classified as such. Most diuretics act directly on the nephron, through activation of specific transport proteins that are located on the epithelial cell membrane. Their role in lymphatic disorders is limited. They are mostly employed post-operatively – provided the patient’s pressure values allow it – as a mild stimulation to kidney function, and in order to control the daily hydroelectrolytic balance.


This condition is brought about when the lymphatic load exceeds the total functional capacity of the total lymphatic circulation system.