The Lymphatic System's Role In Swelling And Injuries

  • Yue Qi Wang  Master of Science - MS, Pharmacology, UCL
  • Eden Mostafa  Integrated Master's, Pharmacy, University of Birmingham


The lymphatic system is a network of tissues and organs that are essential for immune function, fluid balance, and lipid absorption. This complex system is made up of lymph nodes, lymphatic vessels, lymphocytes, the thymus gland, adenoids, tonsils, the spleen, and bone marrow.1 Lymph fluid, a clear fluid that circulates through lymphatic vessels and contains infection-fighting white blood cells, is an essential component. When functioning properly, the lymphatic system often goes unnoticed, but it is essential for transporting fluid, filtering waste, and protecting us from disease and injury.1 

The lymphatic system and edema

To maintain fluid homeostasis, the lymphatic system drains excess interstitial fluid from body tissues and returns it to the bloodstream. Every day, approximately 2 to 3 litres are returned to circulation via the lymphatic system.1 When lymphatic vessels are damaged or obstructed because of surgery, infection, malignancy, or immobilisation, the lymphatic system cannot effectively drain lymph fluid. 

Components and organisation of the lymphatic system

The lymphatic system is a network of tissues, organs, and vessels that maintains the body's fluid balance, absorbs fats and lipids, and defends against microorganisms.2 These are the primary structural components of this system.

Similar to blood vessels, lymph vessels are a network of thin channels that transport lymph fluid throughout the body.3 They consist of larger collecting vessels and small lymphatics or capillaries that absorb lymph from tissues. Additionally, lymph trunks discharge into lymph ducts that connect to veins. 

Lymph Nodes - Small, bean-shaped organs located along lymph vessels and responsible for filtering lymph. They contain lymphocytes, which eliminate unwanted substances, debris, and microorganisms. Hundreds of lymph nodes are dispersed throughout the body.4

Lymph - A transparent fluid derived from interstitial fluid that circulates through the lymphatic system. It is composed of white blood cells, proteins, lipids, and dead organic particles.5

Tonsils/Adenoids - Clusters of lymphatic tissue in the throat that can recognise and eliminate invading pathogens as lymph passes.6 Moreover, located behind the sternum, the thymus gland produces T lymphocytes for the immune system.7 Furthermore, the spleen is an abdominal organ that filters blood and stores lymphocytes to combat infection.8 Additionally, in bone marrow, stem cells produce new blood cells, lymphocytes, and plasmacytes.9 

These lymphatic structures function as a vascular drainage network to regulate fluid balance, transport lipids, and safeguard the body from disease and inflammation.10 

Functions of the Lymphatic System

Fluid equilibrium and circulation

Maintaining fluid homeostasis is one of the lymphatic system's most important functions.2 It functions as a one-way drainage system that returns excess interstitial fluid from tissues to the circulatory system. Without this drainage mechanism, fluids and proteins would accumulate in the tissue spaces, resulting in a dangerous condition called edema.11  

The lymphatic capillaries, or initial lymphatics, absorb excess protein-rich fluid and pass it through lymph vessels that become progressively larger.11 The fluid, now known as lymph, is filtered by lymph nodes before being returned to the circulatory system through the subclavian vessels.11,12 Additionally, the lymphatic system returns plasma proteins that have leaked out of blood capillaries back into circulation, thereby aiding in the maintenance of a healthy blood colloid osmotic pressure.

Immune system assistance

The lymphatic system is an essential component of the immune system.13 Lymph nodes filter lymph fluid and capture microorganisms, debris, and other pathogens. Lymphocytes such as T cells and B cells encounter and eliminate foreign invaders within the lymph nodes. These infection-fighting cells migrate from the blood and lymph node reserves into the lymph fluid. The lymph then transports the lymphocytes throughout the body to provide immune surveillance.14 The lymphatic system and immune system function closely together to protect the body from pathogens and toxins. 

Elimination of wastes and toxins

When interstitial fluid enters lymphatic capillaries, it carries metabolic waste products, bacteria, damaged cells, and cellular debris.15 Before the fluid is returned to the bloodstream, the lymph nodes filter and capture these waste products and contaminants and purify the lymph. Additionally, at sites of injury or inflammation, the lymphatic system eliminates cellular remnants and detritus to assist in the resolution of the inflammatory response. This function of waste removal keeps tissues pure and healthy.16

What causes oedema related to the lymphatic system?

Oedema refers to tissue swelling caused by fluid accumulation.2 The lymphatic system is frequently impaired in these cases. When the lymphatics are unable to effectively discharge this fluid, it accumulates and causes swelling. Several critical factors can cause damage to lymphatic vessels or lymph nodes, resulting in lymphedema or swelling; these include:

Bacterial infections such as cellulitis can lead to lymph node and vessel inflammation and obstruction.17 As lymph nodes become swollen in response to an infection, their capacity to filter lymph fluid decreases.18 The inflamed vessels would also struggle to transport fluid. Additionally, infection increases the permeability of blood vessels, which forces more fluid into the tissues. This combination of excessive filtration and diminished lymphatic drainage results in significant oedema.

Cancer - Malignant tumours frequently disseminate to lymph nodes, displacing healthy tissue and compressing lymphatic vessels.19 This obstruction impedes the effective drainage of fluids through the lymph nodes. The removal of lymph nodes during cancer surgery also damages or severs lymphatic channels.20 

Injury/surgery - Any incision or trauma that damages the complex network of lymphatic capillaries and vessels inhibits their vital drainage function.21 Blunt trauma, burns, and orthopaedic surgery bear a high risk of interfering with lymphatic flow and causing swelling. Scarring from surgery or radiation therapy can also contribute to lymphedema by compressing lymphatic vessels.22

Simple inactivity inhibits the contraction of muscles that ordinarily pump lymph fluid through lymphatic vessels.23 Therefore, paralysis, protracted bed rest, and a sedentary lifestyle can reduce this pumping action and permit fluid accumulation.

Function of the lymphatic system in oedema management

The lymphatic system is essential for preventing and treating oedema. Here are a few of its principal functions:

Drainage and shipping

The network of lymphatic capillaries absorbs excess fluid, proteins, and waste products from the interstitial space and transports them to lymph nodes for filtration.15 Without this constant one-way drainage, fluid would accumulate and produce swelling in the tissues.  

Management of fluid balance

Approximately 1-2 litres of fluid are returned to the bloodstream via the lymphatic system daily.2 This system maintains the equilibrium of fluid levels between the blood and interstitial compartments.12 Ineffective lymphatic drainage results in fluid accumulation in the tissues.

Elimination of proteins

The lymphatics return plasma proteins that have leaked from blood vessels into the bloodstream. This facilitates the maintenance of oncotic pressure gradients between blood and tissue.11 Inadequate lymphatic drainage causes tissue protein accumulation, which increases oncotic pressure and fluid retention.

Management of inflammation

Lymphatic vessels remove excess fluid, inflammatory mediators, and debris from inflammatory and infectious sites.13 This reduces oedema and facilitates the healing process.

When lymphatic vessels or nodes are damaged or overloaded, drainage and conveyance of fluid become stagnant, resulting in oedema with high protein content. Chronic swelling conditions, such as lymphedema, are frequently treated with therapies that improve lymphatic flow.

The impact of common injuries on the lymphatic system

Surgical Procedures/Incisions

Surgical incisions disrupt lymphatic vessels traversing the epidermis and subcutaneous tissues.24 This injury can inhibit lymph drainage from the affected area, resulting in postoperative swelling. Extensive lymph node removal during cancer surgery is also linked to lymphedema and impaired drainage.25

Orthopaedic damage

Fractures or joint injuries can directly harm localised lymphatic vessels or modify limb mobility, both of which aid lymphatic flow.26 This contributes to swelling and oedema, hindering the body's ability to heal and function.


Burns destroy lymphatic capillaries and vessels in the epidermis, resulting in an accumulation of protein and fluid (lymphedema).27 Ineffective drainage promotes inflammation and infection, impeding the healing of burns.

Acute trauma

Contusions and severe contusions can cause the perforation of lymphatic vessels and lymph nodes, compromising drainage capacity. This results in prolonged inflammation of damaged tissues.28

Radiation treatment

Radiation influences the dividing lymphatic endothelial cells, resulting in vessel occlusion and fibrosis that reduces lymph transport and contributes to chronic oedema.29

Physical trauma resulting from surgery, accidents, or treatments such as radiation can cause changes in the lymphatic architecture, thereby contributing to acute and chronic oedema. Facilitating lymphatic flow and drainage is essential for healing.


The lymphatic system is a true unsung hero - it filters interstitial fluid, transports immune cells, and maintains our health. It becomes vitally important when disease, injury, or immobility prevent the body from performing these essential functions. Understanding the functions of the lymphatic system enhances our comprehension of how oedema develops and why discharge is crucial for recovery after trauma. Maintaining the optimal condition of this often-overlooked system is necessary to prevent swelling, combat infection, and promote wound healing.


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This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Raza Siddique

Master's degree, Health Information/Medical Records Administration/Administrator, Swansea University

As a dentistry professional pursuing a Master's in Health Informatics, I leverage expertise in oral healthcare and a passion for technology to advance innovations in digital health. My background includes providing compassionate, high-quality dental care and building strong patient relationships. Currently, I am developing skills in data analytics, system implementation, and workflow optimization to improve health outcomes. I have a passion for research writing and synthesizing complex health information into digestible resources for various audiences. My goal is to utilize my robust clinical knowledge and evolving tech capabilities to enhance interoperability, data security, and care coordination throughout the healthcare ecosystem. I stay attuned to emerging trends in digital health to identify opportunities to increase accessibility, engagement, and value-based care for diverse populations.

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