Lower limb oedema following distal arterial bypass grafting

Lower-limb oedema following arterial bypass surgery for ischemia is a commo n sequela which can complicate wound healing or delay resumption of mobilit y. Its exact pathogenesis remains uncertain but many theories have been pro posed. Lymphatic disruption during arterial exposure, and endothelial damag e from atrophy of the media and oxygen-derived free radical release are cur rently favoured hypotheses. Infrequently, deep vein thrombosis follows surg ery and may exacerbate the condition. Efforts aimed at reducing the oedema, such as the use of lymphatic preserving incisional approaches or the use o f antioxidants, have given conflicting results. The use of compression hosi ery and leg elevation appear to be the most effective measures in reducing postoperative lower limb oedema.