Improving microcirculation in the area of a wound is an important aspect of wound healing. It can be improved by a new manual methodology: myofascial-manual lymphatic drainage (M-MLD). This hybrid technique uses elements of musculoskeletal medicine and manual lymphatic drainage. Through palpation, M-MLD therapeutically affects the functional pathology of soft tissues, with reflection in trigger points, and also the functional pathology of lymphatic system, namely by lymphostasis in particular regional lymph nodes. Most cases of post-traumatic and postoperative conditions lead to dynamic insufficiency of the venous system and subsequently of the lymphatic system. If this is not treated promptly, it can lead to secondary post-traumatic lymphoedema. Early M-MLD treatment eliminates the development of secondary post traumatic lymphoedema and even secondary inflammation, thus decreasing the risk of cicatrix hypertrophy and contributing to faster wound healing and better regeneration of the afflicted area. Laboratory immunological examination of circulating immune complexes support 20 years of the authors' empirical experience. The level of circulating immune complexes before M-MLD reached constant values. After manual influencing of the functional pathology of soft tissue and lymphatic system, the dynamics of circulating immune complexes levels was observed, this is the effect of the improvement of microcirculation in the wound area. M-MLD is time- and cost-saving, but it requires professional training with a very good palpation technique. In the authors' experience, its use is indicated within 2-24 hours from the time of trauma (surgery), and then once a day until healing is achieved. This early manual therapeutic treatment can be delivered not only by physiotherapists, but also nurses working to encourage wound healing, such as in traumatology, surgery and orthopaedics. Using M-MLD makes the total treatment time shorter, and has an economical, biopsychosocial and society-wide impact.
Keywords: Myofascial-manual lymphatic drainage (M-MLD); burn trauma; dynamic insufficiency of lymphatic system (DI-LS) and soft tissues; lymphatic system; wound healing.