Models of the Lymphatic System for Improved Therapy
Abstract
It was only after things really stabilized and we were waiting for a helicopter ride, that I kind of understood what was going on, understood that I lost both of my legs. But, more importantly understood that I wasn t going to be able to be with my guys anymore. US Marine Corps Captain Matthew Lampert stated these words after an improvised explosive device (IED) explosion tore off both his legs while on deployment in Afghanistan. Captain Lampert returned to his troop after 18 months of overcoming nearly impossible odds in rehabilitation. His words attest to the bravery and comradeship of our Soldiers and their unbeatable resolve to continue serving our country, even in the face of life-threating danger. Amputation is a life-changing injury, however, which requires extensive rehabilitation, physiotherapy, and ongoing care throughout the survivor?s life. While some people, such as Captain Lampert are able to thrive, others never succeed in regaining their previous quality of life. In spite of advances in limb-salvaging medical approaches, in cases when muscles, bones, and blood vessels in a limb are too damaged due to injury or disease (e.g., due to diabetes, cigarette smoking, etc.), or when tumor growth requires removal, an amputation surgery is inevitable. As with any surgery, there is initial pain and swelling until the wound heals. Sometimes, however, the swelling does not recede. The pooling of fluid in a body part that causes swelling is called edema. Persistent edema is problematic for the patient. It makes the body part heavy and painful, and inflamed. If the affected part is a residual limb that is being fitted to an artificial limb, the consequences of edema can make proper fitting very difficult. Improper fitting causes pain when wearing the artificial limb and hence, the usage of the artificial limb and therefore mobility are reduced. All these factors contribute to depression and diminished physical health in the amputee. Service members are particularly affected by this problem, as both their risk of traumatic injury while on deployment and their risk of developing diabetes after leaving active duty is higher than that of the general population. The objective of this proposal is to understand why the residual limb swells, after healing is completed. Scientists believe that during the injury in the limb, the fluid transport network, called lymphatic system is damaged. If we understand the mechanism of fluid transport in relation to pressure and flow in the lymphatic system, then we can find ways to reduce the swelling to improve early and better fitting of the artificial limb. We propose to achieve this goal by mathematically describing the properties responsible for drainage of the lymphatic system Currently there are nearly 2 million patients in the US who live with an amputation, many of whom suffer from problems with prosthetics. If our mathematical model of the lymphatic system based on measured anatomy and material properties can help device ways to reduce the recurring swelling, this will greatly improve the comfort of the patient when wearing the artificial limb. If a better fitting artificial limb is worn more, the patient will be more mobile. Better self-image and acceptance of limb loss, and therefore improved quality of life can be achieved. This results in better pain reduction and more exercise, which is crucial, especially to prevent cardiovascular diseases. If we can improve our understanding of fluid drainage after amputation surgery, then we can identify the bottlenecks for flow of fluid. This could allow for development of new therapies; e.g., vary the lymphatic pressure via stenting, shunting or pumping so the fluid can flow better and lymphatic congestion can be eliminated. Service members are at a higher risk than the general population to undergo traumatic amputation and diabetes related amputation. Any of the current 80,000 amputee Service members could
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Mar 05, 2019
- Source ID
- W81XWH1910087
Entities
People
- Ghassan Kassab
Organizations
- United States Army