TREATMENTS OF LYMPHOEDEMA
Complete Decongestive Lymphatic Therapy
CDLT are noninvasive treatments for lymphoedema. The therapy techniques includes SLD (simple lymphatic drainage), MLD (manual lymphatic drainage), IPCT (intermittent pneumatic compression therapy), use of compression garment, exercise and skin care.
SLD - a self massaged drainage technique to direct the lymphatic fluid away from effected areas and towards more ontimally working nodes.
1. Slow breathing inflating abdomen and pressing into belly gently each time
2. Downwards - starting from behind ears with relaxed hands to shoulders x10
3. Inwards - starting at shoulders stroke in hollow of collar bone x5
4. Press - using finger pads press gently behind collarbone in the hollow x3
5. Upwards - left hand in right armpit massaging up and release x10 (never go down)
6. Upwards - starting above waist stroke up into armpit x10
7. Upwards - starting at waist stroke up into armpit x10
8. Upwards - starting at abdomen stroke into waist then waist into armpit x10
9. Upwards - starting at hip stroke up x10
10. Upwards - starting lower and lower stroke out and up gradually making way down leg x10
11. Finish with breathing as before
Hands must stay in contact with the skin the entire time and only gentle pressure applied to avoid irritation
MLD - a more complex massage process using either Vodder, Földi or Casley-Smith technique. These are all similar, but massage movements are a little different for each. Specialists perform this type of drainage
Compression Garments - Class 1-4 comrpression garments which are made to measure to your effected limb. Various styles, colours, fits and aesthetics are available. These are either a flat knit and stitch or a round knit style. Usually worn everyday
Wrap/Bandaging - a manual wrap of bandage which is self manipulated to more progressive areas of the lymphatic fluid build up
Layering - the process of using multiple compression garments over the top of one another at the same time
IPCT - the use of airflow and Flowtron machines to manipulate the fluid of an effected limb with the inflation and tightening of the cuffs
Exercise - light and consistent movement of the effected limb actives the lyphatic system to drain the fluid at a more optimal rate
Skin care - using quality emollient to reduce the risk of sore and broken skin. Ensuring that the lymphoedema effected limbs skin is healthy and clean reduces the risk of cellulitis
Invasive Treatment
LVA - lymphovenous anastomosis is a microsurgery which creates a bypass to connect the lymphatics to small veins in the skin allowing excess fluid to drain from the affected area through a direct new pathway
VLNT - vascularized lymphnode transfera is a transfer of a spare lymphatic from a healthy area of the body to the effected limb with lymphoedema. The healthy lymphatics are connected to nearby blood vessels so the tissue remains healthy and can begin to regenerate lymphatics. The transferred lymphatic tissue can then restore the workings of the lymphatic system
Liposuction - physical removal of the excess lymphatic fluid and tissue when the build up has become dense and old. It is particularyl effective when lymphoedema has been present for a long period of time when the lymphatic have a large build up ratio of fat and protein in comparison to lymphatic fluid
Investigative Treatment
FG-MLD - fluoroscopy guided manual lymphatic drainage is a massage technique to figure out where blockages appear in the lymphatic system. A massage to access the superficial lymphatic vessels, mapping the lymphatics and how it builds up in certain areas. It identifies lymph drainage pathways that work and those that don't. Specialists perform this type of drainage
ICG - indocyanine green scan is a green coloured medical dye injected under the skin and absorbed up the lymphatics, and can be used to map lymphatic function using an infra-red camera. Results are immediate. Normal results show clear lines where the dye has travelled through the lymphatic channels. However, in effected limbs there may be a delay or lack of travelling dye causing star-bursting and spreading of dye indicating where a defect presents
Lymphoscintigraphy - radioactive dye injected into the deeper lymphatic system which show up on a nuclear medical imagine programme to pin point where blockages, damaged or scarred lymph nodes present in the effected limb