Integrative Management of a Post-debridement Non-healing Diabetic Foot Ulcer: A Case Report
Riddhi Ganatra *
Department of Shalya Tantra, Institute of Teaching and Research in Ayurveda, Jamnagar, Gujarat, India.
T S Dudhamal
Department of Shalya Tantra, Institute of Teaching and Research in Ayurveda, Jamnagar, Gujarat, India.
*Author to whom correspondence should be addressed.
Abstract
Diabetic foot, including diabetic foot ulcers, is a major complication that many people with diabetes experience at some point in their lives. Diabetic wounds, especially foot ulcers, are a significant long-term complication in diabetic patients, frequently leading to a decline in their quality of life. This case report describes the successful management of a non-healing diabetic foot ulcer in a 73-year-old male with a 10-year history of type 2 diabetes. The patient presented with a post-debridement wound on the plantar aspect of the right heel, complicated by infection. Treatment involved a combination of local and systemic Ayurvedic interventions, including wound cleansing with Phalatrikadi Kwatha, dressings with Apamarga Kshara Taila and later Yashtimadhu Ghrita, and oral Ayurvedic medications. A posterior below-knee Plaster of Paris slab was applied for offloading. Significant wound healing was observed within two weeks, with complete closure achieved by the ninth week. Microbiological analysis confirmed the resolution of infection. There was no wound recurrence in 1.5 years of follow-up. This case highlights the potential of an integrative approach for managing challenging diabetic foot ulcers. In conclusion, despite the challenges of non-healing diabetic wounds post-debridement, thorough integrative management can yield positive outcomes.
Keywords: Ayurveda, case report, Dushtavrana, diabetic foot ulcer, post-debridement wound