BEWARE AND WATCH OUT FOR NEW MODIFIED TERMINOLOGY AND ACRONYMS DISCRIBING LYMPHEDEMA TREATMENT - Medical Definitions - Lymphedema/Lymphoedema Glossery of Terms - Lympedema Expert Centres of Reference/Excellence

Due to new terminologies and abbreviations that are emerging in the field of lymphedema treatment, it is necessary to take note of the new vocabulary being used by some international lymphedema organizations to denominate the treatment for lymphedema. 

Whilst the International Society of Lymphology and Specialized Societies uses the following term and acronym to designate treatment, "Complete Decongestive Therapy" (CDT), which describes Gold Standard treatment backed by long-standing experience, some organizations are now using the following modified term to describe the treatment, “Decongestive Lymphatic Therapy" (DLT).

It should be noted that there is a big difference between these two descriptions, for they are not the same and they are not substitutive. While the traditional abbreviation "CDT" refers to the need for a combination of all the elements that form part of the Conservative Treatment, the modified abbreviation and term "DLT", refers to treatment in a broad sense, and does not strictly specify the need to use all the elements included in the traditional treatment, especially regarding Manual lymph drainage (MLD) conducted by physiotherapists at specialist level.

The new abbreviation and term "Decongestive Lymphatic Therapy" (DLT) excludes the words "Complete", and so can represent treatment options even without MLD. 

When using the acronym DLT, it can designate and represent many variations of therapies other than the Conservative Treatment, including treatment formed by one single element, such as the use of compression pump devices (IPC) or multi-layer bandaging alone. The term and abbreviation DLT appears thus as an economical alternative to replace the Conservative Treatment, and so to be able to omit the inclusion of Manual Lymph Drainage (DLM) conducted by specialized physiotherapists.

ACRONYM USED TO DESCRIBE LYMPHEDEMA TREATMENT

Acronym and term used by the ISL (International Society of Lymphology):

• CDT - Complete Decongestive Therapy

Acronym and term not used by the ISL (International Society of Lymphology):

• DLT - Decongestive Lymphatic Therapy

What does the Conservative Gold Standard Treatment include:

     1.   Skincare.

2.   Motion exercises.

3.   Manual lymph drainage-MLD ( conducted by physiotherapists at specialist level).

4.   Compression Pumps (it´s optional and can only be used if accompanied by MLD conducted by specialized physiotherapists).

5.   Multi-layered bandage wrapping (conducted by specialized physiotherapists).

6.   Low-stretch compression garments (custom-made and specific for lymphedema).

What does the modified term and acronym “Decongestive Lymphatic Therapy (DLT)” exclude:

1.   It excludes the keyword "Complete", so as not to include Manual lymph drainage (MLD) conducted by physiotherapists at specialist level

2.   It can represent treatment consisting of one sole element, as the use of Pneumatic Pumps (IPC) or multi-layer bandaging alone, without MLD conducted by specialized physiotherapists. This can have serious side effects for patients.

3.    It can represent treatment consisting of simple or modified versions of treatments. Some haven´t sufficient scientific evidence and may lead to irreversible problems in the long run. 

4.    It can represent treatment that suppresses bandaging conducted by a specialized physiotherapist for the reduction of edema, and incorporate patient self-administrated Multi-layer Bandaging. This can cause severe complications for patients without  MLD conducted by physiotherapists at specialist level. 

5.    It can represent treatment that suppresses Manual lymphatic drainage (MLD) conducted by physiotherapists at specialist level, and incorporate Simple Lymphatic Drainage (SLD), a patient serf-administrated version of MLD. The efficacy of SLD as a treatment option for lymphedema does not have sufficient scientific evidence and remains to be proven.

Patients should be specially careful when choosing a lymphedema Multidisciplinary Expert Centre of Reference/Excellence, as not all centers and counties offer or provide the same treatment options. The best choice is the Expert Reference Centre of Excellence that applies Complete Decongestive Therapy (CDT), which is recognized as the "Gold Standard" treatment for Lymphedema. Read more about the components that form part of the Conservative Treatment in the German Scientific Protocol HERE. 

References:

GERMAN SCIENTIFIC SOCIETY GUIDELINE: Diagnostics and Therapy of Lymphoedema.

THE INTERNATIONAL SOCIETY OF LYMPHOLOGY: Consensus Document.

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