The lymphatics of the skin filled by a dermal backflow: an observation in a scarred cadaver leg.
There have been few photographic studies done on lymphatics of human skin with previous images obtained by indirect dye injection into the dermis. We have developed a direct injection technique for investigating the lymphatic system in human adult cadavers and used this to investigate superficial lymphatics of the legs in a fresh human cadaver. We found an unusual observation in a skin graft scarred leg when the radio-opaque mixture injected into a lymph collecting vessel in the dorsal foot filled the skin lymphatics in the mid-lateral pretibial region. Further radiological investigation revealed that the dermal back flow was associated with a blockage of the lymph collecting vessel within the skin graft scar. We also found tracer transport through a circuitous pathway from the blocked collecting vessel to an adjacent intact collecting vessel. The transilluminated image of the skin demonstrated a three dimensional polygon of lymph capillaries and precollecting lymphatics in the dermis.
The Jack Brockhoff Reconstructive Plastic Surgery Research Unit, Royal Melbourne Hospital, Department of Anatomy and Cell Biology, University of Melbourne, Parkville, Victoria, Australia. hsuami@unimelb.edu.au
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D015502:Absorptiometry, Photon; D000369:Aged, 80 and over; D002102:Cadaver; D002921:Cicatrix / Q000473:pathology; D005260:Female; D006801:Humans; D007866:Leg / Q000473:pathology*; D008208:Lymphatic System / Q000473:pathology*; D042601:Lymphatic Vessels / Q000473:pathology; D012867:Skin / Q000473:pathology*