According to the international guidelines of the International Society of Lymphoma, the best global treatment for lymphedema is CDT (complete decongestant physiotherapy) [1]. Numerous studies have demonstrated the effectiveness of CDT in improving lymphedema symptoms such as swelling and pain [2].
This is an intensive program that combines many different treatments, including bandage compression garments, manual lymphatic drainage exercises, and self-care. As a technology, CDT originated in Europe and Australia, but is now becoming more popular in the United States.
CDT
Can effectively reduce the volume of lymphedema
- Improve patients’ mobility
- Increase quality of life.
- Comprises two phases.
The first stage (strengthening stage) involves the flow of fluid and the beginning of a reduction in hyperplastic connective tissue.
The second phase (maintenance phase) maintains swelling reduction and aims to optimize connective tissue reduction. [1]
Components
Complete decongestant therapy (CDT) includes:
- Manual Lymphatic Drainage (MLD): A mild skin stretching technique that stimulates the lymphatic system.
- Compression: Wrap in layers with foam or specially fitted clothing to control swelling.
- Exercises: Special exercises with compressions will help pump lymph out of the swollen area.
- Skin Care: Keeping your skin clean and moisturised can help prevent infections that often occur with lymphedema.
- Self-care management and training: Learn how to manage lymphedema at home in the shower.
Phases
Active Phase (Phase 1)
- The first stage involves the flow of fluid and the beginning of a reduction in the proliferation of connective tissue [1].
- The number of weeks depends on the degree of swelling and the firmness of the tissue.
- Complete an hour of decongestant therapy 4 to 5 days a week.
- Foam bandages are worn about 23 hours a day and are usually only removed
Maintenance Phase (Phase 2)
- Maintenance period to maintain swelling reduction, designed to optimize connective tissue reduction
- Phase 2 should last for months or years. [1]
- Wear elastic compression garments that fit like a second skin during the day.
- Use a foam bandage regularly at night to reduce daytime swelling.
- Movement is performed while wearing compression.
- Perform 20 minutes of self-manual lymphatic drainage per day [2].
