Ayurvedic Management of Dushta Vrana (Trophic Ulcer)

Abstract

Trophic ulcers are chronic, non-healing wounds resulting from impaired neurovascular supply and are commonly associated with peripheral vascular disease (PVD). Conventional treatment modalities include antibiotics, wound debridement, vascular procedures, and, in advanced cases, amputation. This case report highlights the potential of Ayurvedic management as a holistic, non-invasive, and cost-effective approach in treating trophic ulcers complicated by PVD. A 72-year-old male who is not a known case of diabetes mellitus presented with a non-healing trophic ulcer over the left heel since 1.5 years, associated with lower limb oedema, sensory loss, and difficulty in walking. Further clinical examination and investigations revealed chronic thrombophlebitis with sapheno-femoral and perforator incompetence of bilateral lower limb. The patient underwent Ayurvedic interventions for four months which includes internal medications - Guggulutiktakam Kashayam, Punarnavadi Kashayam, Triphala Guggulu, Elasheetasivadi Churnam, and Guggulutiktaka Ghritam and external therapies - local application of Jathyadi Ghritam, Apamarga Ghrita, and Shashtika Taila, along with procedures such as Guduchyadi Kashaya Dhara, Udwarthanam with Kolakulathadi Churnam, Dhanyamla Dhara and Paranthyadi Taila Dhara. Progressive healing of the ulcer was observed with significant reduction in edema, decrease in ulcer size and depth, and development of healthy granulation tissue by the end of the treatment period. This case demonstrates the effectiveness of Ayurvedic management in chronic trophic ulcers complicated by thrombophlebitis. The treatment facilitated Ama pachana, Srotoshodhana, Shothahara, and Vrana Shodhana–Ropana, addressing both systemic and local disease processes.