CHRONIC LIMB SWELLING

Swelling and oedema may be due to systemic causes or are a consequence of an increased local production and decreased removal of interstitial fluid. An imbalance develops between the filtration pressure in the proximal capillary bed and the absorptive osmotic pressure at the venous end of the capillary bed. The glomerulus-like appearance of capillaries in chronic venous insufficiency and the associated increase in the exchange surface contribute to this imbalance with accumulation of water and proteins in the interstitial fluid. The most common causes of limb oedema are indicated in Table 7.1…