Effects of Apamarga Kshara Taila on diabetic pressure ulcer - A case report

Diabetes mellitus is a group of metabolic disorders with chronic hyperglycemia, and Diabetic Pressure Ulcer (DPU) is one of the major complications. DPU develops due to the effect of continuous forces on the distal pulp, causing progressive skin ischemia occurring above bony prominence. 62 million people are affected with diabetes in India, and among that 25 % develop DPU. Neuropathic and ischemic components account for 45 %-60 % of ulcers, which, if untreated, can lead to the risk of amputation. According to Ayurveda, characteristic features of DPU can be correlated with the features of Dushta vrana and treatment can be planned based on Dushta vrana and Madhumehaja vranas. Acharya Susruta highlighted the importance of kshara for wound debridement in treatment of non-healing ulcers. A 63-year-old male with known case of diabetes mellitus for 15 years presented with a wound over the big toe of his right foot. The wound is 9-month-old. It was associated with loss of sensation, swelling, and discoloration. Treatment was given with the external application of Apamarga kshara taila with internal medications for 2 months. The size of the ulcer measuring 1.5cm in length, 1cm in breadth, and 4 cm in depth completely healed by 2 months of treatment. The utilization of Apamarga kshara taila, along with internal medications, has demonstrated significant efficacy in the management of DPU.