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Anhydrous Aluminum Potassium Sulfate Reverses Post-Surgical Chronic Non-Healing Ulcer and Sensory Mononeuropathy: A
Magesh Kirubakaran J P1, Pooja Shrivastav2, R Sangeetha3
1PG Scholar, Department of Shalya Tantra, Mahatma Gandhi Ayurveda College & Research Center, Wardha, Maharashtra, India.
Background:
Chronic non-healing ulcers (CNUs), particularly those complicated by neuropathy and multi-morbidity, represent a profound therapeutic challenge with limited effective interventions. This case study investigates the novel application of topical anhydrous aluminum potassium sulfate (AAPS), a traditional astringent agent, for a refractory postsurgical ulcer with concomitant saphenous neuropathy.
Case Presentation:
A 65-year-old male with poorly-controlled type 2 diabetes mellitus, schizophrenia, and severe alcohol use disorder, presented with a three-year-old, post-surgical CNU inferior to the right medial malleolus. The ulcer had failed multiple courses of targeted intravenous and oral antibiotics and was not amenable to a planned skin graft due to psychosocial constraints. Clinical and neurophysiological examination confirmed severe sensory mononeuropathy of the right saphenous nerve with Utah Early Neuropathy Scale (UENS) score of 9/12.
Therapeutic Intervention And Outcome:
After exhaustive conventional therapy failed, a protocol of once-daily topical AAPS dusting powder was initiated alongside phased mechanical debridement. The intervention resulted in complete ulcer closure within 60 days, with a 57% reduction in surface area observed by day 30. Critically, the patient reported the return of protective sensation (pain) at day 30, and the UENS score improved significantly to 3/12 post-treatment, indicating neurological recovery. No recurrence was noted during a six-month surveillance period.
Conclusion:
This first-reported case demonstrates AAPS dusting as a highly effective intervention for complex CNUs, achieving both tissue repair and neurological recovery. The clinical outcomes align with recent evidence of AAPS-mediated ERK pathway inhibition, suggesting a potential molecular mechanism for its therapeutic action in chronic wounds. These dramatic results warrant controlled trials to validate efficacy and the mechanistic pathways.
Keywords:
anhydrous aluminum potassium sulfate, chronic non-healing ulcer, ERK pathway, nerve regeneration, wound healing.
