Therapy of peripheral lymphedema is divided into conservative (non-operative) and operative methods. The best first-line non-surgical treatment for lymphoedema, considered the "Gold Standard" treatment, is known as "Complete Decongestive Therapy" (CDT).
Complete Decongestive Therapy (CDT) is backed by longstanding experience and generally involves a two-stage treatment program that can be applied to both children and adults and consists of two phases: Phase I is aimed at reducing lymphedema volume and mobilizing the increased interstitial fluid to normalize tissue homeostasis, and the aim of Phase II is maintenance and optimization of the therapeutic success. Earlier treatment is reported for the best results. The frequency and intensity of the components of CDT in Phase I and Phase II should depend on the clinical edema findings and Stage of the lymphoedema and be adapted to clinical changes. The isolated application of single components in Phase I is not recommended, and thus should be used in its entirety.
Complete Decongestive Therapy" is undertaken by a therapist who has undergone training at the specialist level and who combines the following components:
- Skin Care
- Manual Lymphatic Drainage (MLD)
- Multilayer Bandages
- Exercise
- Compression Garments
- Patient Education
- Compression Pumps (this is an optional adjuvant, and must be accompanied by Manual Lymph Drainage (MLD) conducted by therapists at the specialist level)).
After the initial treatment (Phase 1), which includes all the components and is applied daily and lasts several weeks, the next step is the maintenance treatment (Phase 2), which consists of compression by low-stretch garments, skin care, continued exercise, and MLD as needed. In this second phase, which is long-term, the patient is taught self-bandaging for maintenance, basic self-care of the skin, and exercise practice.
The success of CDT therapy depends on it being administered by an experienced certified therapist. CDT is considered safe, however, patients should consult with their physician before beginning treatment. Indications, contraindications, and the application of individual therapeutic measures depend on several factors: the stage of lymphoedema at the start of treatment, comorbidities, the age of the patient, and the patient’s individual life circumstances. Failure of CDT should be confirmed only when intensive non-operative treatment in a clinic specializing in the management of peripheral lymphedema and directed by an experienced clinical lymphologist has been unsuccessful. Read more about the signs, symptoms, and complications of lymphoedema HERE.
In no way should this highly specialized treatment be replaced, due to the possible serious side effects, by edema reduction treatments carried out by non-specialists. Aggressive reduction of swelling can cause skin and vessel damage, Isolated compression therapy of the extremities, particularly in patients with lymphedema also affecting the quadrants of the trunk, may cause displacement of edema and increase swelling at the root of the extremity, and may even lead to genital lymphoedema. Read more about the new low-cost treatment options for lymphoedema HERE.
Patients should be especially careful when choosing a Multidisciplinary Centre of Reference/Excellence for lymphedema, as not all counties and centers provide the same treatment options. The best choice is a center of reference that provides Complete Decongestive Therapy (CDT), which is recognized as the "Gold Standard" treatment for Lymphedema. Read more about what is the key difference between the two main treatment protocols HERE. Read more about which country has the best public healthcare coverage of lymphedema HERE.
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- WHAT KIND OF DOCTOR TREATS LYMPHEDEMA/LYMPHOEDEMA - WHAT TYPE OF DOCTOR IS SPECIALIZED IN LYMPHATIC DYSFUNCTION - WHICH MEDICAL SPECIALITIES ARE RELATED TO LYMPHEDEMA
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TO SEE LYHMPHEDEMA INCIDENCE
AND PREVALENCE
TO SEE LYHMPHEDEMA INCIDENCE
AND PREVALENCE
