International Journal of Life science and Pharma Reviews (IJLPR)  
  Aim and Scope - To publish peer reviewed review articles in rapidly developing field of Pharma and life sciences  
Life Science
Volume 12 Issue 3, May 2022    Pages:7-13
Ayurveda Management of Diabetic Foot Ulcer - A Case Report

Dr.Asma , Dr.Omprakash Dave, and Dr.Hemant D Toshikhane
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Diabetic foot ulcer (DFU) is a major complication of Diabetes Mellitus (DM). DFU treatment principles consist of wound debridement, off-loading and education. Shastiupakrama (60 procedures) principles are explained for the management of Dustavrana(Chronic wound)which has been adopted in this study. The main objective of the study was to see the effect of Ayurvedic treatment in the management of DFU. A 46 years old male presented with the complaints of a non-healing ulcer at left great toe. The patient had a history of trauma with stone during working in the agricultural field and was treated conservatively with antibiotics and anti-inflammatory drugs by his family doctor. Patient was under regular medication for Diabetes Mellitus and Hypertension. On examination revealed an ulcer over the left great toe measuring 3 cm x 2cm with slough and blackish discolouration around the ankle region. Vasculopathy and neuropathy were evident by peripheral arterial palpation and Semmes-Weinstein Monofilament (SWM) test respectively. The case was effectively managed by both internal and external procedures with oral medications.The case was diagnosed as DFU as per contemporary science and Dustavrana(Chronic wound) as per Ayurveda based on laxana. The case was managed with treatment procedures like Chedana(Excision/Debridement), Prakshalana(Wound cleansing), Lepa(Topical application), Bandhana(Bandaging), Jalaukavacharana(Leech therapy), Manjistadi kshara basti(Medicated enema) and Shamanaoushadi(Internal medications). The ulcer took 3 months for complete healing with improvement in the patient's quality of life to perform his routine activities. The adopted Ayurveda treatment has given promising results in the management of DFU. Further research in this aspect with Randomized Controlled Trial is essential.
Keywords: Diabetic Foot Ulcer, Ayurveda, Dustavrana, Shastiupakrama, Vrana Shodhana, Vrana Ropana
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Basiri R, Spicer MT, Levenson CW, Ormsbee MJ, Ledermann T, Arjmandi BH. Nutritional supplementation concurrent with nutrition education accelerates the wound healing process in patients with diabetic foot ulcers. Biomedicines. 2020 Aug 3;8(8):263. doi: 10.3390/biomedicines8080263, PMID 32756299, PMCID PMC7460445.

2.       Theocharidis G, Thomas BE, Sarkar D, Mumme HL, Pilcher WJR, Dwivedi B, Sandoval-Schaefer T, Sîrbulescu RF, Kafanas A, Mezghani I, Wang P, Lobao A, Vlachos IS, Dash B, Hsia HC, Horsley V, Bhasin SS, Veves A, Bhasin M. Single cell transcriptomic landscape of diabetic foot ulcers. Nat Commun. 2022 Jan 10;13(1):181. doi: 10.1038/s41467-021-27801-8, PMID 35013299.

3.       Williams NS, Bulstrode CJK, Ronan O’Connell P. Bailey & Love’s short practice of surgery. 26th ed. Taylor & Francis Ltd.; 2013.p. 887.

4.       Levin ME. An overview of the diabetic foot: pathogenesis, management and prevention of lesions. Int J DiabDevCtries. 1994;14:39-47.

5.       Everett E, Mathioudakis N. Update on management of diabetic foot ulcers. Ann N Y Acad Sci. 2018;1411(1):153-65. doi: 10.1111/nyas.13569, PMID 29377202.

6.       Bhat KS, Vishwesh BN, Sahu M, Shukla VK. A clinical study on the efficacy of Panchavalkala cream in VranaShodhanaw.s.r to its action on microbial load and wound infection.Ayu. 2014 Apr;35(2):135-40. doi: 10.4103/0974-8520.146216, PMID 25558157, PMCID PMC4279318.

7.       Samhita S, Chikitsasthana D. Vol. 01(06). Available from: http: [cited Jun 15 2021]. Available from:

8.       Shukla VK, Ansari MA, Gupta SK. Wound healing research: a perspective from India. Int J Low Extrem Wounds. 2005 Mar;4(1):7-8. doi: 10.1177/1534734604273660, PMID 15860447.

09.     Ajmeer AS, Dudhamal TS, Gupta SK, Mahanta V. Topical application of Katupila (Securinegaleucopyrus) in DushtaVrana (chronic wound) showing excellent healing effect: A case study. Ayu. 2014;35(2):175-8. doi: 10.4103/0974-8520.146238, PMID 25558163.

10.     Balasooriya D, Karunarathna C, Uluwaduge I. Wound healing potential of bark paste of Pongamiapinnata along with hirudotherapy: A case report. J Ayurveda Integr Med. 2021 Apr–Jun;12(2):384-8. doi: 10.1016/j.jaim.2021.01.014. PMID 33814265, PMCID PMC8185996.

11.     Neelambika GB, Balu V, RashelRego M, Kesari C. Integrative approach for diabetic foot management- a case report. J Ayurveda Integr Med. 2018 Oct–Dec;9(4):298-301. doi: 10.1016/j.jaim.2018.06.009, PMID 30545739, PMCID PMC6314231.

12.     Brahmanand T, SharangadharaSamhita MK [reprint. p. 2010]. Ch 9, Ver168-171. Varanasi: ChoukambhaSurbharatiPrakashan; 2010. p. 159.

13.     Baljinder S, Neraji J. Antimicrobial potential of Polyherbo-mineral formulation Jatyaditaila – a review. Int J Res Ayurveda Pharm. 2011;2(1):151-6.

14.     Bhandari M, Rao PN, Shetty SK, Gopikrishna BJ. Ayurvedic enema therapy in the management of thromboangitisobliterans (TAO) - A case study. Med Case Rep. 2018;4(3):75.

15.     Brahmanand T. Vagbhata, AshtangaHridaya, sutra Sthana. ShodhanadiAdhyaya, 15/19-20. Chaukhambha Sanskrit Pratishthan. 2007:199-200.

16.     Ayurvedic formulary of India. Part 1.Government of India Ministry of Health and Family Welfare. New Delhi: Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy; 2003. p. 512-5.

17.     Bates-Jensen BM, McCreath HE, Harputlu D, Patlan A. Reliability of the Bates-Jensen wound assessment tool for pressure injury assessment: the pressure ulcer detection study. Wound Repair Regen. 2019;27(4):386-95. doi: 10.1111/wrr.12714, PMID 30828890.

18.     Gupta V, Keshari BB, Tiwari SK. Murthy KHHVSSN. A comparative study of Shilajatu and Asanadi Ghana Vati in the management of Madhumeha w.s.r. to type-2 diabetes mellitus. Ayu. 2016;37(2):120-4. doi: 10.4103/ayu.AYU 211_15.

19.     Wanjari MM, Mishra S, Dey YN, Sharma D, Gaidhani SN, Jadhav AD. Antidiabetic activity of ChandraprabhaVati - A classical Ayurvedic formulation. J Ayurveda Integr Med. 2016;7(3):144-50. doi: 10.1016/j.jaim.2016.08.010, PMID 27665674.

20.     Bhandari M, Rao PN, B J G, Gudasi D. An integrated approach for the management of diabetic foot ulcer: a case report. J Complement Integr Med. 2019;16(3):2018-0126. doi: 10.1515/jcim-2018-0126, PMID 31365345.

21.     Bhat KS, Vishwesh BN, Sahu M, Shukla VK. A clinical study on the efficacy of Panchavalkala cream in VranaShodhanaw.s.r to its action on microbial load and wound infection.Ayu. 2014 Apr;35(2):135-40. doi: 10.4103/0974-8520.146216, PMID 25558157, PMCID PMC4279318.

22.     R. S, Rao PN. Bhandari M, B.J. G. Vol. 2(3). p. 31-4. TankanamruthaMalahara in the Management of DushtaVranaw.s.r. to Diabetic Foot Ulcer (DFU) - a case study.IJATM [internet]. 2020Dec.25 [cited 2022Jan.16].

23.     Singh SK, Rajoria K. Medical leech therapy in Ayurveda and biomedicine - a review. J Ayurveda Integr Med. 2020;11(4):554-64. doi: 10.1016/j.jaim.2018.09.003, PMID 30709686.

24.     Sathish HS, Dudhamal T, Sanjay G, Bhuyan C, Baghel MS. Overview of academic researches on Vranaropan (tissue healing) properties of ayurvedic drugs. Indian J Anc Med Yoga. 2014;7(1):33-47.

25.     Mitra S, Prajapati PK, Shukla VJ, Ravishankar B. Impact of BhavanaSamskara on physico-chemical parameters with special reference to GandhakaRasayana prepared by different media and methods. Ayu. 2010;31(3):382-6. doi: 10.4103/0974-8520.77155, PMID 22131744.

26.     Hegde P, Hemanth DT, Emmi SV, Shilpa MP, Shindhe PS, Santosh YM. A case discussion on eczema. Int J Ayurveda Res. 2010;1(4):268-70. doi: 10.4103/0974-7788.76792, PMID 21455456.

          27.        Killedar R, Sanapeti R, Shindhe P. Ayurveda management of chronic non-healing pressure ulcer at foot secondary to tethered cord             syndrome – A case report. Indian J Ayurveda Res.2018;1:62-6.

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