ISSN 0976 - 0075
Dusta vranas (Chronic ulcers) are a frequently encountered problem in present era produced commonly as a complication of trauma or pathologic insult and it causes long term agony to the patient. The issue of chronic ulcers management with Ayurvedic panacea is one of the major areas of research and has come under increased scrutiny. It has been an ongoing process to search out better remedies in order to overcome the previous drawbacks. Keeping in view aforesaid problem, ancient literature was explored and formulation Hinsradi Tail as mentioned by Acharya Sushruta and Vagbhata in Vranashodhan Gana in Mishrak Adhyaya and Shodhanadigana sangraha respectively was taken for study. Hinsradi Tail does Vrana Shodhana as well as Vrana Ropana.
Key Word – Dushta Vrana, Shodhana, Ropana, Hinsradi Tail.
Introduction-
Ever since the life originated human being has been susceptible to injury, which made him to think about healing from very early stage of development. Almost every source of life and matter surrounding human beings has been used in some form or other to treat wounds and through a series of clinical experiences; some results were obtained which were transmitted verbally to the respective generations.
In Ayurveda, particularly Sushruta has mentioned various types of vrana and their management which is of prime importance in any surgical practice/procedure. In recent past brilliant progress of surgery in various fields has immensely reduced the incidence of wound infection by decreasing the impediments associated with wound healing to certain limit. Still wound management continues to be a subject of speculation.After injury, healing is a natural phenomenon and continues in sequential manner unti the formation as a healthy scar.
Usually nature takes complete care during healing. The defense mechanism of body like phagocytosis and its local enzymatic action on dead tissue help to keep a wound clean. But at times when infection is massive, surface area of wound is very large and slough or necrotic tissue is too much, this auto cleansing mechanism becomes inadequate. Acharya Sushruta was aware of these facts and has indicated the process by which these impediments can be removed thus paving way for uninterrupted healing. For the management of dusta vrana, he incorporated number of drugs broadly classified into vrana shodhana and vrana ropana. The processes i.e, shodhana and ropana have been therapeutically grouped under seven headings kashaya, varti, kalka, sarpi, taila, rasakriya and avachoorna. It is the need of hour to find out a rational and optimal healing compound for the wound management in a better way. Hence,it is important to find out a single and effective formulation that possesses both vrana shodhana and ropana properties.
There are many measures to create favourable conditions for wound healing such as use of antiseptic solutions and many topical de-sloughing and debridement agents which promote healing but, there are certain drawbacks of these agents like damage to healthy granulation tissue, local skin irritation etc. Since time immemorial, it has been an ongoing process to search out better remedies in order to overcome the previous drawbacks.
Keeping in view aforesaid problem ancient literature was explored and formulation Hinsradi Tail as mentioned by Acharya Sushruta and Vagbhata in Vranashodhan Gana in Mishrak Adhyaya and Shodhanadigana sangraha respectively was taken for study.
AIMS AND OBJECTIVES :
To study management of dushta vrana with Hinsradi Tail application.
MATERIAL AND METHODS :
Source of the data : study is carried out in “IPD of Shalyatantra , Y.M.T. Ayurvedic medical college and hospital , kharghar , navi Mumbai
Type of study : single case study.
CASE REPORT-
A male patient of age 30 yrs. He was complaining of-
Non healing ulcer on lateral aspect of Rt. T6 since 1 Month
Mild itching since 1 month
Discharge since 1 Month
H/O - Injury on lateral aspect of Rt. thigh 4 months back by RTA.
No H/O – DM / HTN/ KOCH’S / Bronchial Asthma
No H/O – Any drug allergy.
P/M/H – NIL
P/S/H- NIL
O/E – G.C- fair
T- Afebrile
Wt - 64 Kg
P- 80/ MIN
B.P.- 120/ 76 mm of hg.
S/E- RS- AEBE Clear
CVS- S1 ,S2- normal
CNS- conscious and oriented properly .
P/A- Soft and non tender.
P/H- Bowel – irregular bowel habit
Bladder –normal habit
Sleep – normal
Appetite - normal.
Addiction :- no any specific addiction
L/E – size- 3-5 cm, Discharge - ++
Tenderness - ++, smell - +
INVESTIGATIONS:
CBC with ESR
Treatment planned as follows:
Application of Hinsradi Tail on Chronic wounds (Dushta vrana).
METHOD
A single patient was selected who was diagnosed as having chronic wound on lateral aspect of Rt. thigh. Data related to the objectives of the study was collected.
An Informed written consent of the patient included in trial in the language best understood by him was taken. C R F was prepared for this study.
Wound was cleaned by Normal saline. Required amount of Hinsradi Tail was taken on sterile gauze and applied directly over the wound and dressing was done. Application of Hinsradi Tail was done till healthy granulation tissue was seen.
DISCUSSION:
Due to Lekhana karma of Hinsradi Tail desloughing action as well as antiadherence effect is carried out which enhances to form healthy granulation tissue.
The main pathology of vrana is Kledotpatti and Rasadidushti which is main medium of growth of bacteria/ krimi in wound.Upshoshan property of Hinsradi Tail breaks this pathology by decreasing elevated Kapha, Pitta Dosha and Rakta.
Hinsradi Tail improves Doshsamanata and correct Rasadidushti by Tridoshaghna, Deepan, Pachan karma.
Hinsradi Tail acts as Krimighna due to its Tikta Kashay ras, Katu vipak, Laghu, Ruksha guna and Tridoshaghna property. All above propertiese opposite of Krimi. Due to these properties it inhibits the growth of Krimi ie: antibacterial effect.
Ushna Vipak and Vatahar karma of Til tail helps to reduce pain in wound management.
Hinsradi Tail promotes to form healthy granulation tissue by debriding the slough of wound.
In the above patient healthy granulation tissue was obtained in about 1 month.
Procedure Discussion on Characteristic features
Size: With the help of ―Prinana‖ and ―Vrana Ropana‖ action of trial drug acted as promoter on rate of contraction.
Pain and Tenderness: By the virtue of ―Shita‖ and ―Shoolhara‖ properties of trial drug the pain and tenderness subsides.
Smell:Hinsradi Tail containing very good fragrance of volatile oil and this is helpful in to bad odour of the infected Vrana.
Discharge: By the virtue of ―Shita‖and ―Katu‖property of trial drug, the discharge is ceased.
Swelling: ―Shothahara‖property of the drug demolishes the ―Shotha‖ (Swelling) of the Vrana.
Infection: The trial drug has ―Krimihara‖ property and Hinsradi Tail has antiseptic property. This is help to sweep out the infections from the wound.
Unhealthy granulation tissue: ―Lekhana‖and ―Shodhana‖ stop the unhealthy granulation tissue in wound. Hence, the Hinsradi Tail has the basic qualities of controlling the cardinal symptoms of the ―Vrana‖, these proves the efficacy of the drug in ―Vrana Ropana‖.
Conclusion:
From the discussion on the subject " Management of Dushta vrana (Chronic wounds) with Hinsradi Tail application”following conclusions can be drawn –
1. Hinsradi Tail has shown Vranashodhaka, Vranalekhana, Putihara, Vedanasthapaka, Vranaropaka, and Jantughna properties in management of non healing ulcers like diabetic wounds, post operative non healing fistulectomy wound etc.
2. Hinsradi Tailis easily available, easy technique to use in Chronic wounds, can be used in tribal areas also, use as home remedy and very cost effective.
3. Even after wound healing and post treatment follow up no adverse reaction found in the present study. Also complication like keloid formation and hypertrophic scar formation are not found in any case.
Before Application of Hinsradi Tail
After Application of Hinsradi Tail
* PG Schlor, Dept. of Shalya-Tantra, Dr. G D POL Foundation’s YMT AMC, Kharghar, Navi-
Mumbai-410210.
** Guide
References:
Sushrut Samhita- Dr.Anant Ram Sharma (1st Edition, Chaukhamba Surbharati Prakashan, Varanasi 2009)
A Short Practice Of Surgery: Hamilton Bailey & Meneill Love.
Ashtang Hridaya- Dr. Brahmanand Tripathi (1st Edition, Chaukhamba Sanskrit Pratishthan, Delhi 2009)
