Complete Decongestive Therapy (CDT)


Complete Decongestive Therapy is a series of clinical sessions aimed at reducing fluid from the body. People with generalized edema, lymphedema and lipo-lymphedema may benefit from CDT. People with lipedema but limited swelling may not benefit much from CDT.
CDT

  • typically includes manual lymphatic drainage (MLD) massage
  • often includes skin care
  • may include exercise or movements to increase mobility
  • may include pneumatic compression pumps
  • may include garments
  • may include wrapping

Severe cases may benefit form CDT being performed in a medical facility.
There are numerous sources with complete information on CDT, so searching via Google or other search engine will provide significant resources. For videos, search YouTube for “CDT complete decongestive therapy”.
CDT can be very effective. One paper follows the case of a patient who “At discharge, after 29 days of treatment, Eva had lost 110 lbs., experienced a volume reduction of 43% in the left leg and 39% in the right—a total loss of 67 L of fluid.” [4]

There appears to be another term, Decongestive Lymphatic Therapy (DLT). Marie Todd describes "decongestive lymphatic therapy (DLT) and use manual lymphatic drainage (MLD) initially until the discomfort is reduced. DLT has been shown to reduce the capillary fragility in lipoedema and thus reduce the haematoma formation (Szolnoky et al, 2008b)."
Bosman states “CDT consists of manual lymph drainage (MLD), physical exercise, multilayered compression bandaging and skin care. In some cases it can be combined with intermittent pneumatic compression (IPC). IPC may improve venous flow and decrease lymph production upon reduction of capillary afterload (Szolnoky et al, 2008). During the ILF conference, the group debated whether IPC is a useful addition to the treatment of lipoedema patients.... The general group opinion (30) was that there is no conclusive data. It was felt that IPC may not be well tolerated and there were doubts as to its effectiveness on patients with lipoedema, due to the absence of fluid components. On the other hand, the group agreed that in some cases it might be useful, for example, in lipolymphoedemas, but always under strict supervision and in combination with MLD.” [3]

References
[1] http://www.lymphnet.org/membersOnly/dl/reprint/Vol_25/Vol_25-N3_Utilizing_CDT.pdf
[2] http://www.lymphnet.org/pdfDocs/NLN_LL_July_2013_sm.pdf
[3] Bosman j, 2011, Lipedema: Poor Knowledge, Neglect or Disinterest
[4] Ryan S, 2007, Functional Gains with Lipo-Lymphedema Treatment