In contrast to the scientifically recognised status of CDT (phases I + II) as first-line
treatment in primary and secondary lymphoedema, initial decongestion of phlebolymphoedema
(stages II + III a/b of CVI according to Widmer/CEAP IV-VI) on an outpatient basis
is largely unknown. As prevention of the further progression of venous lymphostatic
disease and the development of gravitational ulcer, the German Federal Committee of
Physicians and Health Insurers (Bundesausschuss Ärzte-Krankenkassen) incorporated the decongestive phase (phase I of CDT) into the valid Federal Joint
Committee Remedies Directive (Heilmittelrichtlinien), sections LY 1 and LY 2, as early as a decade ago. Provision of the indispensable
medical compression stocking is only advisable after performing the daily phase I
CDT for an average of 10 times up to a maximum of 15 times. Consistent further treatment
as phase II CDT (maintenance phase) is only necessary in exceptional cases following
corresponding medical findings.
Keywords
Complete decongestive therapy (CDT) - prevention of progression of CVI - phlebolymphostatic
oedema - medical compression stocking
