Combined Decongestive Therapy (CDT)
Lymphoedema is a chronic condition characterized by the accumulation of protein-rich fluid (lymph) which results in swelling that occurs in soft tissues. It occurs asa result of the impairment of the lymphatic system. There are two types of lymphoedema, primary and secondary.
Primary lymphoedema has no known cause, and may be congenital, diagnosed at birth, or occur at puberty or after age 35.
Secondary lymphoedema has a known cause. Patients are at risk for developing secondary lymphoedema if they have been treated for cancer, have had surgery, been exposed to radiation, experienced trauma, paralysis or immobility, have had infections, suffer from venous insufficiency, or been bitten by a mosquito carrying filaria.
Combined Decongestive Therapy (CDT) is the treatment of choice for lymphoedema. The therapy is comprised of the Dr. Vodder method of Manual Lymph Drainage, remedial and breathing exercises, therapeutic skin care, compression bandaging and/or compression garments.
Manual Lymph Drainage (MLD) is a special form of gentle massage that removes excess lymph from a lymphoedematous extremity and/or body part and encourages the fluid to move into an area where it can drain away normally.
Compression bandaging (or compression garments during the maintenance phase) uses short-stretch elastic cotton bandages applied to the affected area(s) to increase tissue pressure in the oedematous region which encourages lymph flow.
Remedial and breathing exercises are performed daily while wearing compression bandages or garments. The exercises facilitate lymph flow by engaging the muscle pump and increasing transport rate of lymph through the thoracic duct.
In the management of lymphoedema, meticulous therapeutic skin care is employed to prevent infection.
Manual Lymph Drainage (MLD)
Manual Lymph Drainage is the primary technique used in Combined Decongestive Therapy to encourage excess protein-rich fluid in the tissues to move to an area where it can drain away normally by way of the lymphatic system.
Using a gentle massage with light pressure, Manual Lymph Drainage utilizes circular movementswith a pressure variance producing a pumping action in the tissue. The direction of the pressure follows the direction of lymph flow and relieves the pressure, swelling and pain associated with fluid build-up.
Contraindications to receiving MLD include cases of acute infection, congestive heart failure or blood clots.