Lymphoedema | Combined Decongestive Therapy (CDT)

Combined Decongestive Therapy or CDT is used primarily in the treatment of Lymphoedema, Lipo-Lymphoedema and Venous insufficiency/venous stasis oedemas. It should only be managed by a qualified and registered Lymphoedema Therapist. Our practitioner Lesley Logan is a certified Vodder therapist and is a member of the Australasian Lymphology Association and on the National Lymphoedema Practitioner's Register.
This video explains very simply what Lymphoedema is, how it is treated & managed and demonstrates components of Combined Decongestive Therapy (courtesy of ALA) 

​CDT is a combination of therapies including bandaging and garments to reduce the volume of the affected limb(s) so that it transitions from the reduction phase through to a level whereby it can be maintained without fluctuations in the limb size. CDT helps to reduce the limb volume, relieve oedema, improve the health of the tissue preventing cellulitis/erysipelas, break down of fibrosis and relief from the accompanying pain/discomfort. 

Components of CDT are: MLD/Lymphatic massage, Compression Bandaging, Kinesio Lymph Taping, Decongestive Exercise, Skin Care,
Self Manual Lymphatic Drainage, Compression Garments, Dietary/nutritional assessment - Referral to a physiotherapist or dietician/nutritionalist maybe required to obtain a collaborative positive outcome for the client.

There are 3 important phases which requires full patient compliance for desired results!

​Phase I - Reduction/Intensive phase 1 week (+ 2weeks depending on the individual reduction)

• Measurements taken of limb (ongoing)
• Daily MLD/Lymphatic massage - 5 days each week. (or every 2-3 days depending on the Compression Bandaging system used)
• Compression bandaging applied and worn until next appointment
• Decongestive exercises
• Skin treatment applied under the bandaging

Phase II - Transition phase 2-3 weeks

• MLD treatments 1-2 weekly
• Change to a Wrap/Easy-fit compression garment client can put on themselves
• Decongestive exercises
• Skin care

When results are satisfactory and the limb volume is stable the patient will advance to next stage.

Phase III - Maintenance phase

• MLD treatments 1 x weekly/fortnight for 2 weeks then once per month
• Custom-made Compression Garment fitted - sleeve/stocking
• Decongestive exercises
• Skin/Nail Care
• Daily Self Manual Lymphatic Drainage (SMLD)

Compression Bandaging is used in the treatment of:

• PRIMARY Lymphoedema - congenital conditions, primary anomalies of the lymphatic system. 
• SECONDARY Lymphoedema - post-surgical, malignant, post-radiation.
• Chronic Venous oedemas - Chronic Venous Insufficiency (swelling) of the lower limbs, DVT prevention & Venous ulcer treatment.
• Traumatic Oedema e.g ankle sprains, giving you the correct support/compression for faster recovery following the RICE protocol.​

Compression Garments - Travel/Sports/Medical

You may require a Compression Garment if you have/do any of the following:
Lymphoedema (Leg/Arm), Lipoedema, Varicose veins, Venous stasis oedema, Sports injuries (especially recurring e.g lateral ankle sprains/achilles tendinopathy), Recent surgery (if recommended), Prolonged sitting/standing, Travel - helps with prevention of blood clot (DVT), Pregnancy oedema.

We stock Travel Compression socks (15-20mmHg) at the clinic to prevent DVT (Deep Venous Thrombosis) - all we need to do is measure for your size and you're all ready to jump on that plane! Here's some additional info on long haul travel and risk of DVT 

We also provide a range of Compression Garments in varying classes of compression that can be ordered in. These are an 'off the shelf' sized generically to cater for your individual needs. They are medically graded garments with the graded pressure on the active leg or arm assisting circulation, reducing swelling and inflammation. 

For Medical compression stockings/sleeves you are usually referred by your G.P or Vascular Surgeon. However if you need a replacement/new compression stocking or sleeve you can call Lesley at the clinic direct.

Indications for Compression Garments

• Deep venous thrombosis (DVT) 
• Primary and secondary varicosis (varicous veins)
• Varicosis or oedema during Pregnancy
• After Vein surgery
• To support sclerotherapy
• Chronic venous insufficiency (swelling lower legs)
• Insufficiency of the communicating veins
• Primary and secondary lymphoedema
• Prevention of venous ulcers
• Post operative oedema
• Post traumatic oedema/Sports injuries e.g ankle sprains
• After burns
• Hypertrophic scarring​

Absolute contraindications - Compression garments NOT recommended.

• Severe arterial circulatory disorders 
• Severe neuropathological disorders 
• Severe microangiopathological disorders
• Bedridden patients

​
Relative contraindications - consultation with your GP is required first.

• Very severe oedema
• Weeping dermatitis
• Decompensated heart failure
• Immediately after DVT
• Diabetes

Appointment Notes: 

• For all garments the consultation is FREE of charge 
• A standard consultation can take 20 minutes. This includes measurements taken of the limb(s), discuss what your personal preferences and needs are, plus discuss what is indicated in the referral.
• For best results for fitting your compression garment the appointment will be scheduled earlier in the day before 10am, when the affected limb is at the most rested stage. 
• If you have used a compression garment before, please bring this with you to the appointment.

• You will be advised of the compression garment price at the consultation or prior following a MLD treatment.

Call Lesley at the clinic on (027) 453 6341 to book your FREE consultation or to ask any questions that you may have.

For more online information, resources and support for people with Lymphoedema including their family, friends and therapists check out these valuable resources:
International Lymphoedema Network
Lymphnotes

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