A 55-year-old woman develops a painful, non-pitting swelling of the right lower limb. Lymphoscintigraphy confirms lymphoedema. She is classified as stage II (spontaneously irreversible). What is the gold-standard conservative treatment?
- A Diuretics and sodium restriction
- B Complete decongestive therapy (CDT) comprising manual lymphatic drainage and compression bandaging ✓
- C Intermittent pneumatic compression device alone
- D Surgical lympho-venous anastomosis as primary treatment
Correct answer: B. Complete decongestive therapy (CDT) comprising manual lymphatic drainage and compression bandaging
Explanation
Complete decongestive therapy (CDT) is the gold standard for lymphoedema management, comprising two phases: an intensive phase (manual lymphatic drainage + multilayer compression bandaging + skin care + exercises) followed by a maintenance phase (compression garments + self-massage). Diuretics are contraindicated as they cause protein concentration and fibrosis. Surgical procedures (lympho-venous anastomosis, vascularized lymph node transfer) are reserved for refractory Stage II–III disease.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.