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Complete Decongestive Therapy (CDT)

Complete Decongestive Therapy (CDT)

Introduction

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

  1. Improve patients’ mobility
  2. Increase quality of life.
  3. 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:

  1. Manual Lymphatic Drainage (MLD): A mild skin stretching technique that stimulates the lymphatic system.
  2. Compression: Wrap in layers with foam or specially fitted clothing to control swelling.
  3. Exercises: Special exercises with compressions will help pump lymph out of the swollen area.
  4. Skin Care: Keeping your skin clean and moisturised can help prevent infections that often occur with lymphedema.
  5. 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].

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