Complete Decongestive Therapy
Phase 1 (Treatment Phase): Consists of regular manual lymph drainage, compression bandaging, exercise instruction, skin & nail care, and self care instruction.
Phase 2 (Maintenance Phase): Includes compression garment use, nighttime bandaging or alternative compression, skin & nail care, daily exercise, manual lymph drainage as needed and follow-up visits every 4-6 months.
Manual Lymph Drainage
Manual Lymph Drainage (MLD) is a manual therapy treatment technique which stimulates lymphatic movement using both superficial and deep lymphatic vessels and nodes. The manipulation involved in MLD uses very light pressure to stimulate the lymph vessels that lie close to the surface of the skin. Since these vessels are small and thin, this gentle technique is important. MLD is a skilled manual therapy for stimulating the movement of lymph fluid out of the congested area and returning it to circulation.
Every patient is uniquely challenging. The number and location of lymph nodes removed, nature of scars, the amount and location of fibrotic (hard) areas, skin condition, the type of surgical and/or radiation treatment received and other medical conditions are taken into account to decide upon the best route for stimulating movement of lymph fluid. No one pattern will work for everyone.
Compression therapy occurs with each MLD treatment. Multiple layers of short stretch bandages are applied to the limb, combined with foam in order to achieve gradient compression to prevent the area from refilling with lymphatic fluid. In a later phase of treatment, compression garments are worn.
Specific lymphedema exercises are prescribed. While wearing the bandages, exercises activate muscle and joints, which results in increased lymph flow and, over time, decreased swelling of the limb.
Skin and Nail Care
Because infections can be a serious complication of lymphedema, each patient is instructed in meticulous hygiene to help eliminate bacterial and fungal growth in order to reduce the chance of infection.
Self Care Management
Lymphedema is a chronic condition. Therefore, patients must develop the skills and knowledge to care for it independently. This includes compression garment use, nighttime bandaging or alternative compression, skin & nail care, daily exercise, manual lymph drainage as needed and follow-up visits every 4-6 months.