Complete decongestive therapy phase 1: an expert consensus document

This document was drafted by interdisciplinary experts informed by the evidence and guided by their extensive lymphedema clinical experience at the 2023 American Cancer Society (ACS) Lymphedema Summit: Forward Momentum: Future Steps in Lymphedema Management hosted by the ACS, Lymphology Association of North America, and the Washington School of Medicine  in St. Louis, Missouri. Consensus statements were derived from a facilitated workshop and multiple follow-up discussions and meetings combining available evidence and clinical expertise. The consensus statements find that the essential components of complete decongestive therapy (CDT) are examination, compression, manual techniques (this may include but is not limited to manual lymph drainage), exercise, skin care, education, and self-management. Adjunctive interventions and alternatives may complement CDT. CDT should be provided by specifically trained healthcare practitioners in lymphedema management, preferably a certified lymphedema therapist. The individual's lymphedema etiology and presentation, comorbidities, and other pertinent clinical information will determine the components of CDT applied and the frequency and duration of care.