Professional Training for the Treatment of Lymphedema

The Godoy Lymphedema Drainage School was created by Godoy & Godoy based on experience accumulated over more than 15 years. During these years, the Godoy Clinic has developed two new manual lymph drainage techniques, a new concept in mechanical lymph drainage, lymph drainage devices that require either active or passive participation of the patient and new designs of garments using a different fabric for compression therapy. The new approach to lymphedema provides many different options depending on the individual needs of each patient, including both long-term and very intensive treatment programs. Intensive programs can reduce lymphedema volume by around 10% per day in the first week, that is, around 50% within one week.

The Godoy & Godoy manual lymph drainage technique was developed using recent changes in our knowledge of the anatomy, physiology and pathophysiology of the lymphatic system associated with the general principles of hydrodynamics. In this technique each movement has been scientifically evaluated and thus can be reproduced in in vivo, in vitro and clinical studies. Two important clinical trials that assessed this manual lymph drainage technique over a period of one and 30 months are of particular interest.

Cervical stimulation, a completely new idea in manual lymph drainage, was developed in the Clinica Godoy; when this technique is used for periods of 15 to 20 minutes, it reduces edema in any part of the body. The technique can be used in isolation or associated with the Godoy & Godoy manual lymph drainage technique. Moreover, it can be used in young children and used to drain the head and neck without manual lymph drainage where compression therapy is impractical.

A new concept of mechanical lymph drainage was created incorporating lymph drainage devices for both the arms and legs. This approach has facilitated the implementation of intensive lymphedema treatment programs. Devices for active exercising have been developed allowing the standardization and quantitative evaluation of treatment and thus the possibility of performing scientific studies.

A new fabric has allowed the development of handmade low-stretch (< 50%) compression garments that remove, in many cases, the necessity of using bandaging. This new option has made the use of compression much easier as patients can dress the garment and take it off when they want without the need of a professional.

Another line of research that was developed was an evaluation of the movements of the arms and legs with the objective of making use of the natural pathophysiology of the human body to treat lymphedema. Hence, the best drainage option is identified for each patient. Moreover synergic effects on combining different therapies have been studied.

These innovations have provided a breakthrough in the treatment; it is possible to reduce completely or, at least, almost completely the volume of the lymphedema in more than 95% of patients with Grade I and II lymphedema within a few days or weeks. In Grade III lymphedema (elephantiasis) a similar reduction is possible in most patients. Fibrosis did not form in any patient during treatment and so the progression of treatment was not hindered. This experience in the treatment of lymphedema is offered to professionals who want to advance their knowledge about these new concepts.

The courses are continuously supervised with certification of professionals on completion after an assessment of their knowledge. The training courses are taught in the Godoy Clinic however other international centers are being adapted.

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