Manual lymphatic drainage in chronic venous disease: A forgotten weapon in our armory

Objectives: The objective of this study is to evaluate the effect of manual lymphatic drainage (MLD) on venous flow and its effect on wound healing in patients with advanced chronic venous insufficiency (CVI). Design: This was a prospective nonrandomized cross-sectional study. Setting: Participants were assessed from a group of patients presenting to a vascular clinic at a tertiary care center, in South India. Participants: Thirty-eight patients with the venous ulcers were enrolled in this study. Intervention: MLD was applied by a certified physical therapist to the lower limb following a standard protocol. The patient and the caregiver were also educated on methods of MLD so as to carry on the treatment in a home-based setting. Main Outcome Measurements: Subjective analysis of symptom relief and ulcer healing were analyzed at 1 week and at 6 months. Results: There was a significant improvement in patient symptoms with respect to ulcer healing and reduction of edema. Conclusions: MLD is an important adjunct in the treatment of advanced CVI