Integrated Management of Digital Gangrene in a Diabetic Elderly Patient: A Case Report

Diabetic foot ulcers and digital gangrene are severe complications affecting 6-10% of diabetic patients worldwide, particularly elderly individuals with poor glycemic control, leading to limb loss, reduced quality of life, and substantial healthcare costs. This case report describes the integrated management of digital gangrene in a 70-year-old male with Type II Diabetes Mellitus (HbA1c 8.0%) presenting with a 15-day nonhealing wound on the left fourth toe that turned black, accompanied by pain, bilateral lower limb discoloration, edema, constipation, and depression. Diagnosis was confirmed via clinical findings (swelling, redness, tenderness), labs (FBS 108-116.9 mg/dl, PPBS 175.6 mg/dl), and peripheral angiogram showing arterial stenoses/occlusions. Treatment combined modern medicine—IV Durataz 4.5g, Pantoprazole 40mg, Tramadol, Sitagliptin+Metformin, Ecosprin 150mg, Clopilet 75mg, Linezolid 600mg (13-04-2025 to 01-05-2025)—with minor distal phalanx amputation on 01-05-2025 without local anesthesia. Ayurvedic interventions included Manjistadi Kshara Basti (Sukumara Ghrita 80ml Anuvasana, Manjistadi Ksharakashaya 300ml Niruha), Kseerabala Taila Pichu, Matra Basti (Panchagavya Ghrita), Jatyadi Taila dressings, and internals (Meha Abhaya, Maha Manjishtadi, Punarnavastaka Kashayas; Nimbadi Guggulu). Post-treatment, pain/inflammation subsided, wound granulated steadily, edema resolved, mood improved, and mobility was regained by discharge. Modern therapies controlled the infection, glycemia and circulation; Ayurveda aided detoxification, vata pacification, and regeneration. This synergistic approach highlights potential for limb salvage in diabetic gangrene, warranting further research on standardized integrative protocols.