Combined Decongestive Therapy (CDT) is an intensive program that combines many different treatment approaches including bandaging, compression garments, manual lymph drainage (MLD), exercise, education, and self-care.
How it works
Combined Decongestive Therapy (CDT) is considered the gold standard of treatment for progressed lymphedema. Many studies have demonstrated the effectiveness of CDT in improving lymphedema symptoms such as swelling and pain. Lymphedema can be managed with effective treatment, but there is no cure!
The therapy has two phases.
- Intensive phase: the goal is to reduce swelling with compression bandaging, lymphatic drainage, good skincare, and exercise. The Combined Decongestive Therapist is very involved during this phase.
- Maintenance phase: the goal is to keep your condition stable with a compression garment and ongoing skin care, regular exercise, and self-massage for lymphatic drainage. During this phase, you will take charge of your care and will learn which options work best for you.
Your treatment plan will depend on your stage of lymphedema, degree of swelling, and phase of treatment.
Combined Decongestive Therapy has the following four components:
- Manual Lymph Drainage (MLD): Manual lymphatic drainage gently moves the excess lymph out of a swollen area into healthy lymph vessels that drain into the bloodstream. It also reroutes lymph into existing pathways to improve the lymphatic return to the bloodstream.
- Compression garments: The use of compression garments increases tissue pressure and is effective in reducing and maintaining swelling. It improves venous and lymphatic return, supports muscle pump during activity, and slows down progression.
- Education: Includes basic information about the lymphatic system and the causes of lymphedema, as well as prevention and management skills, including self-massage techniques, skin care and risk reduction strategies, and the use and care of compression bandages/garments.
- Exercise Program: A balanced exercise program includes Diaphragmatic breathing, stretches, strengthening, and aerobic exercises. They are all important aspects of maintaining a decrease in swelling. A specific exercise program to follow at home is provided.
Compression
Compression garments are a key component in the management of lymphedema. The term “compression” refers to mechanical pressure exerted from the outside onto skin and tissue.
Key Facts about Compression Therapy
Compression therapy plays a central role in the treatment of venous edema and lymphatic disorders. It serves two main purposes:
- to reduce swelling caused by fluid filtration in the tissues
- to reduce venous reflux and venous hypertension
Special medical compression stockings and bandages are used to apply this pressure to the affected limb. Tissue repair in wounds of venous origin can also be improved with compression by reducing venous pressure. The skin and tissue are then under less strain and can be better supplied with nutrients, such as oxygen. Wounds of a purely venous origin can also be managed with compression therapy.
How can compression treatment help me with my venous disease?
Compression therapy for legs means wearing special medical compression stockings that come in different lengths and styles, to suit a variety of venous diseases and individual needs. So, why wear compression stockings? Because they help to normalize the blood flow, close venous valves better again, and ease typical problems such as heavy legs. For this reason, compression stockings may also help to reduce heavy, swollen legs during pregnancy or long days of sitting or standing at work. Compression therapy is also a good solution for people who regularly take long flights or journeys: compression stockings for travel are specially designed for this purpose.
Medical compression for lymphedema
Lymphedema is a disorder of the lymphatic system, whereby lymph fluid accumulates in the tissue space and is unable to drain properly due to physical damage to or abnormality of the lymphatic system. This causes swelling and discomfort in the affected limb. Compression treatment exerts pressure from the outside onto the tissue, increases the interstitial pressure, and supports fluid transport and recovery in the lymphatic system. Thereby fluid accumulation is counteracted, which helps to maintain the volume and shape of the affected body part of lymphedema clients.
Prevention with compression
Compression garments can also be worn for pain relief and to prevent swelling of the legs. Preventative compression is particularly important for those with healthy veins and lymphatic vessels in reducing the risk of developing edema and similar conditions.