Fibrosis

Fibrosis due to radiation. © Lymph Notes

Introduction

The term fibrosis is a noun that describes the formation of fine scar-like structures that cause tissues to harden and reduces the flow of fluids through these tissues.

The term fibrotic is a verb meaning pertaining to fibrosis or the hardening of tissues. As shown here, radiation is one cause fibrosis. It can also be caused by chemotherapy, burns, and the improper treatment of lymphedema.

How Fibrotic Tissues Form

In the early stages of lymphedema, the tissues swell with protein-rich lymph and cannot drain properly. These tissues are soft to the touch and pressure leaves an indentation that takes time to fill back in. This is known as pitting edema and you can read more about it by reading How Lymphedema is Diagnosed.

If the lymphedema is not treated at this stage, the stagnant lymph causes fibrosis within the affected tissues as the disease progresses to Stages 2 and 3.

• As fibrosis develops, normal tissues are replaced by scar-like structures that create obstructions and make lymph drainage even more difficult.
• The amount of swelling is not an indicator as to the risk for developing fibrosis. Fibrosis can occur in tissues that are only moderately swollen.
• Because this lymph cannot drain properly, the protein molecules accumulate in the tissues and cause more fibrosis and a greater danger of infections.
• Fibrosis can be felt as the tissues are no longer flexible or soft.
• As these changes increase, so too do the risks of more swelling, tissue infections, and skin problems.

Potential Complications of Fibrosis

The tissues are further damaged because the fibrosis prevents tissue fluid from bringing essential nutrients to the cells. This produces increased toxic waste products surrounding the cells within these tissues.

Because the lymph cannot flow to the lymph nodes where pathogens would be destroyed and the fluid would be filtered, the danger of infection increase. These tissue changes result in infections within the tissues and open wounds that do not heal properly.

Treatment

As the tissue hardens different massage techniques, using more pressure, are required as recommended by the patient's lymphedema therapist.

References

[1] Foundations of Manual Lymph Drainage 3-E by M. Földi and R. StröBenreuther. Elsevier Mosby, 2003.

[2] Living Well with Lymphedema by A. Ehrlich, A. Vinjé-Harrewijn PT, CLT-LANA, and E. McMahon PhD. Lymph Notes, 2005.

[4] The Lymphatic System Pathology by B. Lasinski in Implications for the Physical Therapists 2-Ed C.C Goodman, W.G. Boissonnault, and K.S.Fuller. Saunders, 2003.

© LymphNotes.com 2009. This information does not replace the advice of a qualified health care professional.

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Category: What is Lymphedema? Updated: 2009-11-13