Integrating ayurveda and conventional medicine for wound healing

Background: Chronic wounds affect around 6.5 million patients in the United States.  The burden for wound management is growing rapidly and the recent report showing about twenty five billion dollars spent annually. Over the last two decades there has been increasing literature about various methods related to the wound healing. The drug resistance and side effects of medications have led many people to search for alternative treatments. There has not been much literature available about the integrative wound care.

Objective: To evaluate and explain the effect of the integration of conventional medicine and ayurveda for the management of chronic wound.

Clinical Features: A female 52 year old patient, presented with non-healing chronic wound on the right leg with 7/10 average pain for 5 years. Patient is also suffering from morbid obesity, venous reflux and lymphedema.  The local findings revealed a foul smelling deep wound with pus, yellow slough. Initial measurement of 21cm length x 16cm width  0.3cm depth. Culture and sensitivity swab report indicated the presence of pseudomonas and MRSA infection with multiple drug resistances. Other laboratory findings showed normal comprehensive metabolic panel and normal complete blood cell count. MRI revealed no osteomyelitis.  Previously the patient has completed multiple courses of antibiotics specific to culture and sensitivity along with compression wraps, collagen stimulating dressings and wet to dry dressings. There was no improvement in the wound with these modalities.

Interventions and Outcomes: Wound depth was measured during different stages of healing along with photographic images. Patient was given integrative care which consist of conventional and ayurvedic medicine. Conventional medicine approach consisted of Ciprofloxacin 500mg twice daily for 10 days, compression leg wraps and diuretics. Ayurvedic protocols include washing the affected area with Triphala decoction daily and application of wound dressing with Turmeric powder, neem bark powder and Medihoney daily. Marma therapy was performed weekly. Patient was also suggested kapha pacifying diet and lifestyle according to ayurveda

Results and Discussion: It was observed that the deep seated slough, started to dissolve from the base and wound started to heal on after one week. Patient reported less drainage, less odor and less pain. The margin of wound became bluish showing growing epithelium. Visual images were taken every week. On sixth week it is observed that wound is completely healed with normal skin coloration. In ayurvedic literature non healing ulcer is referred to as dushta vrana. The characteristics of dushta vrana were noted in this patient. Sushrutha the father of surgery enumerates 60 measures for the management of the non-healing ulcers. Among those measures paste of herbal ingredients and decoctions of various herbs for treating the chronic wounds has been explained. In the current study conventional drug therapy was supportive to the ayurvedic external wound care. 

Conclusions: This case study discusses the use of integration of ayurvedic herbs with conventional medicine for the management of wound healing. Larger studies with randomized control trails should be conducted to better understand the effectiveness of this integrative approach.