The lymphatics of the skin filled by a dermal backflow: an observation in a scarred cadaver leg.

There have been few photographic studies done on lymphatics of human skin with previous images obtained by indirect dye injection into the dermis. We have developed a direct injection technique for investigating the lymphatic system in human adult cadavers and used this to investigate superficial lymphatics of the legs in a fresh human cadaver. We found an unusual observation in a skin graft scarred leg when the radio-opaque mixture injected into a lymph collecting vessel in the dorsal foot filled the skin lymphatics in the mid-lateral pretibial region. Further radiological investigation revealed that the dermal back flow was associated with a blockage of the lymph collecting vessel within the skin graft scar. We also found tracer transport through a circuitous pathway from the blocked collecting vessel to an adjacent intact collecting vessel. The transilluminated image of the skin demonstrated a three dimensional polygon of lymph capillaries and precollecting lymphatics in the dermis.