A comprehensive program to improve patients’ mobility and health
Lymphedema is an accumulation of excess fluid in the body’s connective tissue. Most often seen in the arms or legs, lymphedema can develop when lymphatic vessels are damaged or absent. The acute swelling often causes discomfort and decreased mobility, and patients are prone to infection and cellulitis.
There is no cure for lymphedema because damage to the lymphatic system is irreversible. But the Combined Decongestive Therapy program at Baptist Rehab-Germantown offers a practical and long-lasting solution to lymphedema sufferers, allowing even those with severe cases to lead a normal, active life.
Manual Lymphatic Drainage Therapy requires a physician order.
Combined Decongestive Therapy (CDT)
CDT is the most effective lymphedema treatment available. Developed by Doctors Emil and Estrid Vodder, CDT is unique because it first decongests the lymph system of the neck and trunk and allows excess fluid to be gradually directed back into the lymphatic system and eliminated.
CDT Comprises These Five Major Elements
Manual Lymph Drainage (MLD)
Manual lymph drainage (MLD) is performed by gently and lightly massaging the skin to facilitate removal of stagnant fluid, toxins, and bacteria from tissue via the lymph vessels. Baptist Rehab-Germantown offers the only Vodder-trained physical therapist in the Mid-South region.
Affected limbs are bandaged in a precise manner so the pressure of muscle contractions within the firm bandage shell provides the pumping action necessary to remove excess lymph fluids and proteins. Our therapist will teach you or a family member how to bandage yourself.
During exercise, your muscles contract against your bandages, this helps facilitate continued movement of the lymphatic fluid. Exercise also improves your flexibility and conditions you to participate in everyday activities. Your therapist teaches you specific exercises appropriate for your condition.
Skin Care and Hygiene
Excellent skin cleansing with antibacterial washes and use of pH-balanced lotions helps eliminate bacterial and fungal growth and minimizes attacks of infection, cellulitis, and lymphangitis.
Your diet may affect the swelling of an extremity. Limiting salt intake is critical for lymphedema sufferers. Losing weight can also help reduce swelling and improve your mobility. Your therapist can obtain a consult with a dietitian as part of your program.
Typical CDT Program
Phase I: Treatment - Your program typically consists of one-hour MLD treatment sessions, 3-5 days per week for approximately four weeks. This includes massage, compression bandaging, and education about lymphedema, exercises, and instruction on self-management techniques. The treatment phase will end when your therapist believes you have achieved the maximum possible reduction of your swelling.
Phase II: Maintenance - After treatment, you may wear a custom-fitted compression garment to maintain the reduction achieved. You should continue to follow proper skin care and nutritional guidelines, continue exercising, and do a nightly bandaging of your limb, if needed.
Follow-up - Checkups every six months are recommended to ensure the best long-term results.
Factors that Contribute to Lymphedema
- Combined surgery and radiation therapy
- Combined surgery and postoperative infection
- Infections (e.g., insect bites, athlete’s foot, paronychia)
- Sedentary lifestyle
- Constrictive clothing or jewelry
- Heavy breast prosthesis
- Trauma to remaining lymphatics (sunburn, surgery)
- Recurrent tumor