Integrative Evidence-Based Ayurvedic treatment and Jalaukavacharana in the Management of Dushta Vrana: A Case Report

Abstract

In Ayurvedic literature, "Vrana" refers to a disruption in tissue continuity. At the same time, "Dushta Vrana" denotes a chronic, non-healing wound characterized by persistent imbalances in the Doshas and deeper involvement of the Dhatus, particularly Raktha (blood). These wounds are similar to chronic ulcers described in modern medicine and are associated with prolonged morbidity and a decreased quality of life. A 38-year-old male professional driver presented with a chronic non-healing ulcer located on the lateral aspect of the right ankle joint, which had persisted for one year. The clinical features observed included irregular wound margins, an unhealthy ulcer bed exhibiting discoloration (Krishna–Rakta), foul discharge, localized edema, intermittent pain, and delayed healing. A history of previous trauma to the same area was reported, alongside contributory lifestyle factors such as chronic smoking and alcohol consumption. Based on a thorough Ayurvedic clinical assessment, the condition has been diagnosed as Dushta Vrana of venous origin. The patient was managed according to Ayurvedic principles of Vrana Shodhana and Vrana Ropana. Jalauka Avacharana (leech therapy).  was used as the primary intervention to address Raktha Dushti and local venous congestion, with appropriate local wound care and internal medications. Clinical parameters such as pain, discharge, discoloration, edema, wound morphology, and granulation tissue formation were assessed periodically. Following intervention, the ulcer demonstrated significant clinical improvement, including reduction in pain, discharge, and surrounding skin discoloration, along with healthy granulation tissue formation and progressive wound healing. This case study demonstrates that classical Ayurvedic interventions, particularly Jalauka Avacharana, can be effective in managing Dushta Vrana. The findings suggest that Ayurveda offers a viable complementary approach for chronic non-healing ulcers, warranting further controlled clinical studies.