Effective Managemant Of Dushta Vrana (Chronic Venous Insufficiency (CVI) With Venous Ulcer): A Case Report

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.