Ayurvedic Management of a Large Sacral Pressure Ulcer (Duṣṭa Vraṇa): A Case Report

Abstract

Background: Pressure ulcers are chronic wounds commonly observed in bedridden patients and are
associated with prolonged pressure, impaired circulation, and delayed tissue repair. In Ayurvedic
literature, chronic non-healing wounds may be correlated with Duṣṭa Vraṇa and are managed through
systematic wound cleansing, healing measures, and internal support.
Case Presentation: A 62-year-old bedridden man presented with a 9 × 6 cm Stage III sacral pressure
ulcer associated with pain, foul odor, and purulent discharge. The ulcer had shown negligible
improvement despite approximately two months of prior antibiotic dressings.
Therapeutic Intervention: The Ayurvedic treatment protocol comprised daily Vraṇa Dhūpana for 14
days using Guggulu, Nimba, and Haridrā. After the wound became clean, Jātyādi Taila Picu dressing
was initiated. Internal medications included Triphalā Guggulu, Ārogyavardhinī Vaṭī, and Gandhaka
Rasāyana. Serial clinical assessment over six weeks included pain, wound discharge, granulation
tissue, wound contraction, and epithelialization.
Outcomes: By Day 14, foul odor and purulent discharge had decreased and granulation tissue was
evident. By Day 28, wound contraction with healthy granulation was observed. By Day 42, marked
wound contraction, epithelialization, and pain relief were documented. No adverse effects were
reported during the treatment period.
Conclusion: This single case suggests that a classical Ayurvedic wound-care protocol may have
potential as an adjunctive approach in the management of chronic pressure ulcers. However, causal
effectiveness cannot be established from a single case, and further systematic clinical evaluation is
warranted.