Complete decongestive therapy (CDT) is a full system treatment approach to managing lymphedema. Many patients respond very well to this gentle, non-invasive, and highly effective treatment. CDT involves 4 main steps: manual lymph drainage massage (MLD), compression bandage therapy, exercise, and skin care.
Manual lymph drainage is a very light massage technique used to help stimulate the movement of lymph within the lymphatic and circulatory systems. Our approach to MLD is to focus on redirecting the lymph from the affected limb, around the blocked or damaged vessels, and into the healthy vessels that drain into the circulatory system. MLD is also used to help promote general relaxation and has a detoxification effect on the skin and superficial fascia.
Compression bandage therapy is an application of multiple layers of short stretch bandages to the affected limb. These bandages are applied after an MLD treatment and are used to prevent the re-accumulation of lymph within the limb between treatments. Bandages are to be worn until the next treatment and will continued to be used until the limb has been decongested. Once the limb has been decongested then the patient will be fitted for a compression garment.
Therapeutic exercises will be given to the patient to preform at home with the bandages on. These exercises are very low impact and are used to help activate the muscle and joint pumps that will further stimulate the flow of lymph within the affected limb.
Proper skin care and client education is vital for lymphedema patients, as infections such as cellulitis and erysipelas are very common complications of lymphedema. Clients will be educated on what products are best used to maintain a healthy skin care routine, how to watch for early signs of infections, and when to seek further medical attention.