Lymphedema Treatments
There are non-surgical and surgical options for lymphedema treatments. Most of the time, it is recommended that the patients, especially patients with stage 0 to stage 2 lymphedema, attempts the non-surgical treatments before exploring the surgical options.
Complete Decongestive Therapy - General
Complete decongestive therapy (CDT) is a non-invasive treatment for lymphedema. There are four key components of CDT: manual lymphatic drainage, compression therapy, exercise, and skincare. CDT manages and relieves the symptoms of lymphedema, but does not completely cure lymphedema. The goal of the therapy is to achieve maximal limb volume reduction.
Complete decongestive therapy has two distinct phases: intensive therapy and maintenance therapy. Intensive therapy takes place in a medical setting with certified lymphedema therapists (usually occupational therapists certified in lymphedema). Maintenance therapy begins in the medical setting and proceeds at home where patients perform self-care techniques learned from the therapy.
Complete Decongestive Therapy - Techniques
Intensive complete decongestive therapy
Therapy is performed in an outpatient medical setting by occupational therapists certified in lymphedema. Therapists work with physicians to develop and implement a treatment plan to meet patients’ immediate and long-term goals and needs.
Intensive CDT includes:
Manual lymphatic drainage
Manual lymphatic drainage (MLD) is a gentle stretching massage technique that reroutes congested lymphatic fluid around blocked areas and drains it out of the body.
Compression garments and bandages
Compression garments and compression bandages are worn on the affected area. The multilayer compression bandages soften the affected area. Compression garments have to be custom ordered and fitted in order to cater to patient’s need.
Exercises
Exercises help move the fluid away from the affected area.
Skincare
When the lymphatic system is compromised, patients are exposed to a higher rate of skin infection. Therapists apply skin lotions and moisturized the skin to prevent skin infections.
Maintenance of complete decongestive therapy
When patients finish the intensive complete decongestive therapy, occupational therapists certified in lymphedema will teach patients how to continue their treatment at home. Patients will learn how to wear compression garments and skincare techniques. Patients will also be given a Home Exercise Program to continue to exercise while wearing the garments.
Surgical Options for Lymphedema:
Liposuction:
Once lymphatic fluid spills into your surrounding tissues, it can cause inflammation and stimulate fat stem cells to grow. Your surgeon removes this extra fat caused by lymphedema. Liposuction for lymphedema is typically an outpatient procedure with a very short recovery time.
Lymphovenous bypass:
Your surgeon uses microsurgical techniques and equipment to reroute your lymphatic system, bypassing damaged nodes and connecting lymphatic channels directly into your veins. The lymphovenous bypass is an outpatient surgery. You can return to regular activity within a few days.
Lymphovenous transplant:
Your surgeon transplants a group of lymph nodes from a healthy part of your body to the affected area, effectively rewiring the lymphatic system. This is an inpatient procedure with a recovery time of a few days before you can resumie regular activity.
Charles procedure:
Affected tissue is removed and your surgeon uses part of it as skin grafts to repair the area. Skin grafts require more extensive care of the surgical site after your procedure, and it can take up to one month to return to normal activity.