Multidiscipliary approach of Ayurveda and conventional principles in the management of diabetic foot ulcer - DFU: A Case Report

Abstract

Background: Diabetic foot ulcer is a frequent complication of diabetic mellitus that constitutes a considerable burden in terms of direct medical expenditures, as well as prolonged hospital stays and disability periods. Clinical findings: This case report presents a foot ulcer of traumatic onset, in a 60-year-old male with a long history of type 2 diabetes mellitus. He was initially unaware about the ulcer till foul smell started to appear and presented to the out patient department of Shalya Tantra with a big ulcer at the foot with blackish discoloraion. It was diagnosed as a Madhumehajanya Vrana (diabetic foot ulcer).  Intervention: After careful clinical evaluation, an integrative treatment plan including surgical wound debridement, medicinal leech therapy, wound care with Ayurvedic remedies, offloading using plaster casts, and a combination of Ayurvedic and allopathic medications for diabetes management was planned. Outcome: Gradually there was a significant reduction in infection, improved wound appearance, and complete healing achieved within 13 weeks. No adverse reactions were reported during the treatment, and no recurrence was observed throughout the 31 month follow-up period. Conclusion: Four week old diabetic foot ulcer of wagner grade 04, was successfully managed through a multidisciplinary approach that integrating Ayurvedic and allopathic wound care principles, thereby avoiding amputation. This case highlights the potential of integrating  Ayurvedic and conventional approaches in diabetic foot ulcer management. Randomized controlled clinical trials, comparative clinical trials and black box study designs can be conducted to substantiate these findings.