Wound Management in Ayurveda

What is wound?

• Any damage leading to a break in the continuity of the skin is called as a wound.

Types: The non-healing type of ulcers are pathologically classified into three; viz.

• Non-specific ulcers
• Specific ulcers and
• Malignant ulcers

 

A non-healing or chronic wound is defined as a wound that does not improve after four weeks or does not heal in eight weeks. These include: Diabetic foot ulcers* Venous-related ulcerations. Non-healing surgical wounds. E.g. Traumatic ulcer Varicose ulcer Tropic ulcer Diabetic and most of arterial diseases Wound Healing Process Healing of skin wounds provides a classical example of combination of regeneration and repair. Healing of a clean wound, unless influenced by adverse factors, starts a few hours after the infliction. Normally it does not require any specific treatment for the healing to proceed in its sequential pattern. But this natural process of healing is not very often allowed to happen, on account of various retarding factors. So it is very important to know the healing pattern and the factors which interfere in the normal process of healing.The wound healing process consists of series of highly complex interdependent and overlapping stage. Vrana(Wound) chikitsa in Ayurveda Vrana is so called as it cover the site, and the scar even after healing does not disappear till the person lives. Important classification based on clinical aspect

• Shuddha Vrana
• Dushta vrana
• Ruhyamana vrana
• Rudha Vrana

According to Charaka – Vata Pitta and Kapha vitiated by their respective causes get located in external passage (Bhairmarga Samashrita) and thus produce innate (Nija) Vranas. E.g.: Madhumehaja Vrana, Role of Pitta dosha in the samprapti of Dushta Vrana: When the vitiated Pitta gets aggravated in due course of time it overcomes the Vata and Kapha Doshas forcibly and thus sets up the suppurating phenomena through the blood. Vitiated Pitta burns (vitiates) the Rakta and results in the formation of pus (Chakra and Dalhana). Management: Sushruta has described the sixty manifold measures (Shastivranopakarma’s) for a wound management from its manifestation to the normal rehabilitation of the  scar. And given foremost to, measure like Shodhana and ropana in the management of Dushtavrana. Shodhana: Shodhana comprises two varieties of purification.

• Antargata Shodhana (internal purification)
• Bahirgata Shodhana (External purification)

Internal purification done by Vamana, Virechana, Vasthi Karma’s of Five manifold measures of Panchakarma’s and external purification are done by two methods. One is Raktamokshana and another is application of medicines.

Ropana: Ropana means a factor, which promotes or quickens the healing process. At present the modern system of medicine could not find such karma which promotes the process of healing except anti-infective and debriding agents. But the great ancient surgeon, Sushruta gave his attention towards the Ropana. Sushruta mentioned the ropana process in the form of kashaya, Varthi, Ghrita, Taila, Choorna, etc.

If pus is not properly cleaned from the site of wound then what happens?

As the fire blown up by the wind, reaches the jungles (paddy fields) and burns it rapidly, similarly the pus which has not been drained out (form the wound) eats away the muscle, vessels and nerves.