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Lymphedema Management

CDT — Complete Decongestive Therapy

The gold-standard conservative lymphedema programme — Manual Lymphatic Drainage, compression bandaging, exercises, skin care and garment fitting at PeriFORMÉ Pune.

4–6 wkIntensive Phase
Daily SessionsFrequency
LifelongMaintenance
Non-SurgicalApproach
What Is It?

The Foundation of All Lymphedema Management

Complete Decongestive Therapy (CDT) is the internationally recognised gold-standard conservative treatment for lymphedema. It consists of two phases: an intensive Phase I that actively reduces the limb, and a maintenance Phase II that preserves the reduction long-term. CDT is the first-line treatment for all stages of lymphedema and is continued alongside and after any surgical intervention.

Manual Lymphatic Drainage (MLD) — Specialised gentle massage technique that stimulates lymphatic flow, re-routes fluid around blocked areas and promotes drainage.
Compression Bandaging — Multi-layer low-stretch bandaging applied after MLD to maintain volume reduction and prevent re-accumulation.
Therapeutic Exercises — Specific limb exercises performed in compression to activate the muscle pump and augment lymphatic flow.
Skin & Nail Care — Meticulous hygiene and moisturising protocol to prevent breaks in the skin that can trigger cellulitis infections.
Custom Compression Garments — Precise measurement and fitting of graduated compression sleeves, stockings or garments at the conclusion of Phase I.

Ideal Candidates

Any stage of primary or secondary lymphedema
Post-cancer treatment arm or leg swelling
Filariasis-related lymphedema
Lymphedema following any cause — infection, trauma, radiation
Maintenance after LVA or VLNT surgery
Patients who are not surgical candidates
The Process

Step-by-Step Journey

01
Initial Assessment

Dr. Thusay performs a comprehensive lymphedema assessment — limb circumference measurements, skin condition review, lymphoscintigraphy if indicated, and staging.

02
Phase I — Intensive Treatment (4–6 weeks)

Daily MLD sessions by a trained therapist, followed immediately by multi-layer compression bandaging. Exercises and skin care education.

03
Volume Reduction

Progressive volume reduction measured weekly. Phase I continues until a plateau is reached.

04
Garment Fitting

Custom compression garments are measured and ordered at maximum reduction. Proper donning and doffing technique taught.

05
Phase II — Lifelong Maintenance

Garments worn daily. Home MLD, exercises and skin care continued. Regular clinic review with Dr. Thusay for reassessment and garment replacement.

Questions & Answers

CDT — Complete Decongestive Therapy for Lymphedema — FAQs

Yes — CDT and MLD are highly specialised techniques developed specifically for the lymphatic system. The pressure, direction and sequence of strokes are precisely designed to stimulate lymph capillaries and redirect fluid around blocked areas. Regular massage does not achieve this and can actually be harmful in lymphedema.

CDT controls and manages lymphedema — it does not cure the underlying lymphatic damage. Consistent long-term management prevents progression and maintains quality of life. Discontinuing CDT allows the limb to swell again.

Each MLD + bandaging session takes approximately 45–75 minutes depending on the limb size and extent of lymphedema.

Compression garments (sleeves for the arm, stockings for the leg) are made to measure and must be replaced every 6 months, as elastic fibres degrade with daily washing and use.

Yes — CDT is continued and modified after LVA or VLNT surgery as the lymphatic reconstruction develops. Surgery and CDT are complementary, not mutually exclusive.

Phase II maintenance is largely home-based — self-MLD, exercises and garment wear. Dr. Thusay's team provides thorough education so patients can manage confidently between clinic visits.

MLD is safe during cancer treatment in the vast majority of cases. It is NOT contraindicated by active cancer — a misconception. Dr. Thusay follows current international lymphedema management guidelines.

The full CDT programme is available at both PeriFORMÉ clinics — Baner and Sasoon Road. Sessions are by appointment and coordinated with Dr. Thusay's clinical review schedule.

Book Your Consultation

Dr. Pranav Thusay will personally assess your case and create a tailored plan.

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