Chronic Venous Insufficiency (CVI) is a progressive vascular disorder of the lower limbs, often presenting with non-healing ulcers, pain, and edema. Venous ulcerations result from elevated ambulatory venous pressure or venous hypertension, leading to limb edema. In Ayurveda, such clinical features closely resemble Duṣhṭa Vraṇa(~ chronic venous ulcer), a chronic wound characterized by dusky discoloration, foul discharge, and delayed healing. This case illustrates the integration of classical Ayurvedic therapies and evidence-based wound care principles to effectively manage chronic venous insufficiency and promote closure of a longstanding venous ulcer. A 45-year-old male presented with a chronic, non-healing ulcer over the left lower limb, with associated edema and discoloration, persisting intermittently for 10 years. Doppler studies revealed dilated superficial veins with an above-ankle perforator. The case was diagnosed as Duṣhṭa Vraṇa based on Ayurvedic principles. An integrative Ayurvedic protocol was administered including Udvartanam (~powder massage), Pācana-Dīpana (~digestive and appetizer correction) with Mahāśaṅkha Vati(~Herbo-mineral tablet for dyspepsia and abdominal disorders) and Pañcakola Paṇīya(~Digestive Herbal Infusion of Five Pungent Herbs), followed by Śodhana (~purificatory therapy) in the form of Virechana Karma (~therapeutic purgation). Snehapāna (~internal oleation) was advocated with Guggulu Tikta Ghṛita for 4 days. Abhyanga (~oil massage) and Svedana (~sudation) were performed later during Viśrama Kāla (~resting phase). Wound management included Pariṣeka (~wound irrigation) with Guggulu Pañcapāla Kaṣāya, application of Daśāṅga Lepa (~herbal paste), and external use of Śatadhauta Ghṛta (~processed ghee). Post-Śodhana internal medications and proprietary formulations were prescribed during follow-up. Significant improvement was noted by Day 30 with complete wound healing, reduction in discoloration and edema, and no recurrence during follow-up. The case demonstrated a successful outcome using Ayurvedic treatment as a holistic alternative. This case highlights the effectiveness of Ayurvedic principles and Pañcakarma (~five detoxification procedures) therapy in managing chronic venous ulceration. The integrative approach demonstrated promising results in wound healing and systemic detoxification, warranting further clinical exploration.
Sethi et al. (Thu,) studied this question.