The ulcers / wounds also known as chronic wounds that do not heal in a predictable amount of time are considered non-healing wounds. Chronic wounds frequently stay too long in the inflammatory stage and may take years or never heal. The wound is usually a sore on the skin or a mucous membrane accompanying the disintegration of tissue. The symptoms are- swelling, redness, discharge, bleeding, and pain in the affected area.
In Ayurveda, Chronic ulcers are known as Dushta Vruna. In normal individuals, the natural process tends to heal Vruna and protect them from Dosha Dushti. But in several cases, underlying conditions like Madhumeha (Diabetes) hinder the natural course of wound healing. This is due to vitiation of doshas.
Pitta imbalance- leads to a burning sensation, infection of blood & ulcer wound
Vata imbalance- leads to swelling and pain
Kapha imbalance- leads to accumulation and vitiation of fluids.
Healing these wounds involves balancing all the doshas. Ayurvedic treatment for non-healing wounds involves- Vamana therapy (wounds on the upper body), Virechana therapy (wounds on the lower body), Swedana, Lepa, Upanaha, Abhyanga, Shodhana, Seevana, Kshalana, etc. These therapies are selected based on individuals' conditions. Further, the treatment is accompanied by the intake of herbs like Vacha, Latakaranja, Pippali, Nimba, Sariva, Kalmegha, etc. The entire procedure helps to reverse the condition in a completely natural way.
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The progression of these non-healing wounds is in stages:
Stage 1- It involves redness of the skin
Stage 2- The symptoms at this stage include pain, friable granulation tissue, foul odor, etc.
Stage 3- Breakdown of wound instead of healing.
Thus, it is essential to treat such wounds/ lesions as early as possible and avoid further complications and complete deterioration of tissues.
Diabetes affects blood circulation and causes blood to move slowly. Thus, wounds heal slowly or do not heal at all. Uncontrolled blood sugar levels might harm the local nerves and numb the area's senses. As a result, individuals with diabetes who suffer injuries to their feet may not be aware of the harm done. It may also affect individuals’ collagen production, healing hormones, and weaken the skin barrier.
Ayurveda terms this condition as ‘Madhumehajanya Vruna’. Amputation of the foot can be avoided, and sugar levels can be managed with skin that has clearly healed. Through Antaha-Parimarjana (internal drugs) and Bahir-Parimarjana (external applications) Chikitsa, Diabetic wounds can be healed. This involves therapies like Swedana, Lepa, Upanaha, Abhyanga, Shodhana, Seevana, etc.
Diabetic ulcers are caused by poor circulation, hyperglycemia, nerve damage, and wounded feet. The causes of diabetic foot ulcers are elaborated below.
Atherosclerotic arteries are a prominent source of arterial ulcers. Ischemic ulcers are another name for them. The arteries are in charge of distributing nutrients and oxygen to various tissues. Clogged arteries restrict the flow of nutrient-rich blood to the extremities. This leaves an open wound. Other causes of arterial ulcers are-
The most frequent form of leg ulcer is a venous ulcer. They are caused by vein injury. The veins are in charge of transporting blood from various regions of the body to the heart via one-way valves. These valves prevent blood from leaving the heart. Other causes of venous ulcers are-
Bedsores, also known as pressure ulcers and decubitus ulcers, are skin and underlying tissue damage caused by continuous pressure on the skin. The causes of pressure ulcers are-
The Vruna Chikitsa is done in three stages:
In order to prevent prameha upadravas from becoming incurable, they must be appropriately controlled using sodhana procedures. Furthermore, the purification of blood by raktamokshana is added to aid the recovery process. Jalaukavacharana therapy (leech therapy) is also employed to enhance tissue oxygenation, which is a prerequisite for the wound healing process.
The entire treatment enhances the regeneration of new blood vessels by circulating pure blood to the affected skin. Thus, the Raktha sodhana concept of Ayurveda, particularly the Jalukavacharana, offers a practical, accessible strategy for the healing of wounds that has the effect of restoring microcirculation.
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