The Four Components of Complete Decongestive Therapy:

1. Manual Lymph Drainage (MLD)
MLD is a light form of manual therapy that involves specific movements along Iymphatic pathways that empty and decompress obstructed Iymph vessels. Such therapy, facilitates the unhindered flow of Iymph fluid into the venous circulation, where it is supposed to go.

2. Bandaging and Compression
Bandaging of the affected limb follows each MLD session. The bandages used for this purpose are minimally elastic and compensate for the diminished tissue pressure in Iymphedema. This is an important component of the therapy because it augments the diminished tissue pressure and prevents the affected limb from refilling with stagnant Iymph. The bandages are worn overnight until the next MLD session is about to begin. At the end of the course of treatment when the limb is close to normal, an elastic support garment is ordered for each patient.

3. Meticulous Skin and Nail Care
Hygienic skin care with or without antibiotics is essential. The aim of this treatment is to eliminate bacteria and fungal growth either of which can lead to repeated attacks of cellulitis and/or Iymphangitis. Meticulous skin and nail care are taught and practiced. Low pH lotions are used to reduce the chance of infections.

4. Remedial Exercises
Remedial exercise with the bandages in place are prescribed for every patient. This step activates the muscle groups of the swollen limb increasing the dilation and contraction of the vessels while helping to propel the fluid from the limb.

Follow Up Maintenance
Home maintenance is simple and effective. With proper attention to the techniques learned during therapy the patient now has control of the affected limb. Both patient and family will receive instruction during the period of therapy on the essentials of Manual Lymph Drainage, importance of weight control, skin care, how to avoid infections and other related subjects. Follow up examinations are recommended every six months.