Multimodal Ayurvedic approach in the management of Sirajanya Dushtavrana (Chronic venous Ulcer): A Case Report
DOI:
https://doi.org/10.70066/jahm.v14i5.2714Keywords:
Basti, Case report, Chronic venous ulcer, Sirajanya dushtavrana, Vrana bastiAbstract
Background: Chronic venous ulcers are caused by valvular incompetence and are considered as serious complication of chronic venous insufficiency (CVI) which can lead to cellulitis, infections, osteomyelitis and eventually require amputation. Ulcer (Vrana) in Ayurveda has been explained in detail by Acharya Susruta. In this case, it denotes chronicity, painful), discharge, and is associated with venous system, etc. were suggestive of sirajanya dushtavrana (chronic venous ulcer). Ayurvedic interventions focused on shodhana and ropana therapies. Clinical findings: A 61-year-old non diabetic female presented with chief complaints of a non-healing ulcer of size 15X8X0.5 cm with pain and discharge above the medial malleolus of the right lower limb, and was diagnosed as sirajanya dushtavrana. She had the same history two years back and had taken treatment, but the condition persisted with delayed healing. Intervention: Treatment initiated with rookshana karma (dry inducing therapy) and Deepana (Digestion stimulating) medicines, snehapana (internal oil therapy) virechana (purgation therapy) followed by basti (medicated enema) and Vrana Basti were adopted along with proper wound care and internal medications. Outcomes: Wound healed completely with tissue epithelialization, scar formation and significant reduction in pain was achieved without any complications, in duration of 30 days of treatment, and 5 months of follow-ups. Follow-up was uneventful. Conclusion: This case demonstrates successful management of chronic venous ulcer of size 15x8x0.5 cm is completely healed and change of VAS from 6 to 0. using a multimodal ayurvedic approach, including classical snehapana, virechana, basti, Vrana Basti and internal medications. Treatment duration was approximately 30 days and 5 follow-ups were done in every month, with no adverse effects and recurrence. Complete healing was achieved in 6 months. This case suggests the efficacy of holistic ayurvedic therapies and proper wound care in the management of long-standing venous ulcers.
References
Robles-Tenorio A, Ocampo-Candiani J. Venous Leg Ulcer. In: Stat Pearls [Internet]. Treasure Island (FL): Stat Pearls Publishing; 2026 [cited 2026 Mar 18]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK567802/ PubMed PMID: 33620871.
Bhat P, Desai AS, Saraganachari BG, Poojashree NK, Navya R. A comprehensive approach to the management of venous ulcers (Vrana) – A case report. Journal of Ayurveda and Holistic Medicine (JAHM). 2025 Mar 16;13(2):49–55. doi:10.70066/jahm.v13i2.1568
Silverberg J, Jackson JM, Kirsner RS, Adiri R, Friedman G, Gao XH, et al. Narrative Review of the Pathogenesis of Stasis Dermatitis: An Inflammatory Skin Manifestation of Venous Hypertension. Dermatol Ther (Heidelb). 2023 Mar 22;13(4):935–50. doi:10.1007/s13555-023-00908-0 PubMed PMID: 36949275; PubMed Central PMCID: PMC10060486.
O’Meara S, Cullum NA, Nelson EA. Compression for venous leg ulcers. Cochrane Database Syst Rev. 2009 Jan 21;(1):CD000265. doi:10.1002/14651858.CD000265.pub2 PubMed PMID: 19160178.
Vaidya Yadavji Trikamji Acharya, Narayan Ram acharya (editors) commentary: Nibandasangraha of Dalhanacharya on Susrutha samhitha of Susrutha, Chikitsastana, chapter 1, verse no.7, reprint edition. Varanasi: Chaukhambha Sanskrit sansthan;2017 ;397
Vaidya Yadavji Trikamji Acharya, Narayan Ram acharya (editors) commentary: Nibandasangraha of Dalhanacharya on Susrutha samhitha of Susrutha, Chikitsastana, chapter 1, verse no.8, reprint edition. Varanasi: Chaukhambha Sanskrit sansthan;2017 ;397
Sreechand SSR, Hemalata K, Shindhe PS, Arya MS, Anil A. Ayurvedic approach to the management of Dry Gangrene (Vrana Kotha) In Peripheral Vascular Disease: A case report. Journal of Ayurveda and Holistic Medicine (JAHM). 2025 Jun 19;13(5):168–75. doi:10.70066/jahm.v13i5.1805
Singh SK, Rajoria K, Sharma S. An ayurvedic approach in the management of Siragatavata complicated with Dusta Vrana. Journal of Ayurveda and Integrative Medicine. 2021 Jan;12(1):151–5. doi:10.1016/j.jaim.2019.10.006
Kadegaon M, Mahadevi, Arakeri S. Utility of Vrana Basti in the management of Venous Ulcer. A Single Case Report. International Journal of Multidisciplinary Research Review. 2023 Feb 13; Vol 5: 1-6. doi:10.36948/ijfmr.2023.v05i01.1393
Chhatriwala AF, Shetty L, Dubewar A, Kunjir H, Raut SJ, Camblay G. Efficacy of wound healing (Vrana Ropana) after lobuloplasty with and without panchavalkala extract. 5% w/v - randomized control trial. Natl J Maxillofac Surg. 2025;16(1):91–7. doi:10.4103/njms.njms_2_24 PubMed PMID: 40510722; PubMed Central PMCID: PMC12156842.
A LB, Purohit R, Kumar V, Joshi S, Shailesh. Rectal Drug Administration and Ayurvedic Basti Therapy: An Integrative Narrative Review. International Journal of Ayurveda360. 2025 Dec 15;2(3):811–9. doi:10.63247/3048-7390.vol.2.issue3.3
Khagram R, Mehta CS, Shukla VD, Dave AR. Clinical effect of Matra Basti and Vatari Guggulu in the management of Amavata (rheumatoid arthritis). Ayu. 2010;31(3):343–50. doi:10.4103/0974-8520.77167 PubMed PMID: 22131737; PubMed Central PMCID: PMC3221069.
Amarprakash D, Sanket D. A clinical study to evaluate the antiseptic and bactericidal effect of yashtimadhu ghrita in non-infected surgical wounds [Internet]. Vol. 2. 2019 Mar 12;2(3):249–52. Available from: https://api.semanticscholar.org/CorpusID:53324952}
Additional Files
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 sreechand s r, anjali sudhakar, arya ms, pradeep shindhe
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors retain the copyright of their work and grant the Journal of Ayurveda and Holistic Medicine (JAHM) the right of first publication. All published articles are licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) license, which permits non-commercial sharing, use, distribution, and adaptation with proper attribution and the same license terms.
JAHM ensures free, irrevocable, worldwide access to its content. Users may copy, distribute, display, and share published works for non-commercial purposes with appropriate credit to the author(s) and the journal. Limited printed copies for personal, non-commercial use are allowed under the same license.
If a submission is not accepted for publication, the author(s) will be notified.
By submitting, authors confirm that the work is original, that all listed authors have contributed and approved it, and that it does not infringe any third-party rights or duplicate work submitted elsewhere.
