Human and equine manual lymphatic drainage

Case Studies

“Mrs D.S.”, lymphoedema of lower leg and knee replacement complications

This patient, suffering from lymphoedema of the lower leg, sadly had to undergo a knee replacement revision after the first replacement knee joint became infected. This meant an incision from the knee to the lower calf, to remove a section of muscle, as well as a skin graft. Infection and poor wound healing are common in lymphoedema, and can be extremely challenging to treat. Prior to surgery, a comprehensive programme of MLD, Hivamat treatment and Coban lymphatic compression bandages were used to get the limb into the best condition and lowest limb volume possible. A specialist team, consisting of Consultant Orthopaedic Surgeon, Mr James Murray and Consultant Plastic Surgeon Mr Umraz Khan, together with other lead professionals, were responsible for the revision which took place at the Spire Bristol Hospital. The operation and post operative healing went extremely well, and it was a privilege to have been involved and assist the patient through a difficult time.


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I had been living with lymphoedema of the lower leg for some years, when I went in for a knee replacement operation on the lymphoedematous leg. Sadly, the knee joint became infected shortly after surgery and I was referred to a specialist unit in Bristol for revision surgery. Rebecka came with me to my pre surgery appointments to ascertain where the surgeons were going to make incisions and take skin grafts from, as she was concerned about the lymph drainage of my leg being adversely affected by scar tissue. She did an intensive bandaging session prior to surgery using the 3M Coban bandages which allowed me to get my shoes on, and we managed to get all the excess fluid of of my leg. The operation was a success, and both the orthopaedic and plastic surgeons were very pleased with how the leg looked. Recovery was difficult due to having to take lots of antibiotics, but I followed up post surgery with more MLD, and the knee and leg are both looking good.

Mrs D.S.