Due
to new terminologies and abbreviations that are emerging in the field of
lymphedema treatment, it is necessary to take note of the new vocabulary been used
by some international lymphedema organizations to denominate the treatment for lymphedema.
Whilst the International Society of Lymphology and Specialized Societies continue to use
the following term and aronym to designate treatment: Complete Decongestive Therapy (CDT), which describes Gold Standard treatment backed
by long-standing experience, some organizations are now using the following modified term to describe treatment: “Decongestive
Lymphatic Therapy (DLT)”.
It
should be noted that there is a big difference between these descriptions, for they
are not the same and they are not substitutive. While the traditional abbreviation CDT refers to the need for a combination of all elements that form part of the Conservative Treatment, the modified abbreviation and term DLT, refers to treatment
in a general way, without strictly specifying the need of all the elements
included in the traditional, specially regarding Manual lymph drainage (MLD) conducted by physiotherapists at specialist level.
The new abbreviation and term Decongestive Lymphatic Therapy (DLT) excludes the words "Complete", and so can represent treatment even without MLD .
When using the acronym DLT, it designates and represents many variations of therapies other tan the Conservative Treatment,
including treatment formed by a single element, such as the use of compression
pump devices (IPC) or multi-layer bandaging alone. The term and abbreviation DLT appears thus as an economical alternative to replace Conservative Treatment, so as to able to include Low-Cost treatment options, such as self-drainage (SLD), and so the omission of Manual
Lymph Drainage (DLM) conducted by specialized physiotherapists.
ACRONYM USED TO
DESCRIBE LYMPHEDEMA TREATMENT
Acronym and term used by the ISL (International Society of
Lymphology):
- CDT - Complete Decongestive Therapy
Acronym and term not used by the ISL (International Society of Lymphology):
- DLT - Decongestive Lymphatic Therapy
What does the Conservative
Gold Standard Treatment include:
1. Skin care.
2. Motion exercises.
3. Manual lymph
drainage-MLD ( conducted by physiotherapists at specialist level).
4. Compression Pumps
(it´s optional and can only be used if accompanied by MLD conducted
by specialized physiotherapists).
5. Multi-layered
bandage wrapping (conducted by specialized physiotherapists).
6. Low-stretch
compression garments (custom made and specific for lymphedema).
What does the modified term and acronym “Decongestive Lymphatic Therapy (DLT)” include, or exclude:
1. It excludes
the keyword "Complete", so as not to include Manual lymph drainage (MLD) conducted by physiotherapists at specialist level
2. It can
represent treatment consisting of one sole element, as the use of Pneumatic
Pumps (IPC) or multi-layer bandaging alone, without MLD conducted by specialized physiotherapists.
This can have serious side-effects for patients.
3. It can represent treatment consisting of simple or modified versions of treatments. Some haven´t sufficient scientific evidence, and may lead to irreversible problems on the long run.
4. It can represent treatment that suppress for the reduction of edemas, bandaging conducted
by specialized physiotherapists, and incorporate patient
self-administrated Multi-layer Bandaging. This can cause severe complications for patients.
5. It can represent treatment that suppress
Manual lymphatic drainage (MLD) conducted by physiotherapists at specialist level, and incorporate Simple Lymphatic Drainage
(SLD), a patient serf-administrated version of MLD. The efficacy of SLD as treatment for lymphedema does not have sufficient scientific evidence, and remains to be proven.
References:
GERMAN SCIENTIFIC SOCIETY GUIDELINE: Diagnostics and Therapy of Lymphoedema.
THE INTERNATIONAL SOCIETY OF LYMPHOLOGY: Consensus Document.
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CAMPAIGN
For global awareness it is being asked that the
WHO - WORLD HEALTH ORGANIZATION,
name:
"LYMPHEDEMA - AWARENESS & CURES"
as the World Health Day campaign
KATHY BATES
LYMPHEDEMA EMBASSADOR