Healing with integrative management of Diabetic foot ulcer - A case report

Diabetic foot ulcers (DFUs) occur in 15-25 % of diabetic patients at some point in their lifetime. The wide surgical debridement of the septic area is the cornerstone of diabetic foot ulcer treatment. There is a need to explore alternate therapies for DFU to reduce the risk of severe amputation. A 50-year-old male visited the Ayurveda OPD with a chronic ulcer on the plantar aspect of his right forefoot, which had persisted for two months. Ayurveda has considered Dushta vrana (∼septic nonhealing ulcer) and mentioned the Vrana upkrama (∼wound care measures) for its management. Among these Vrana upkrama, Jalauka avcharana (∼bloodletting using leech), Vrana Shodhana (∼wound cleansing measures) by Parisheka (∼therapeutic streaming of medicated decoction), Vrana ropana (∼wound-healing measures) are the three main wound care approaches along with Shamana (∼palliative therapy) for three months adopted in the present case for managing diabetic foot ulcers. DMIST tool was used to assess wound care at baseline and during follow-up. After three months of treatment, the integrated approach effectively shortens the healing time of DFUs, reduces the amputation rate and improves the standard of living of patients with DFUs with multiple Ayurvedic treatments.