A Single arm clinical study to evaluate the wound healing efficacy of Jalaukavacarana in the managemnet of venous ulcer (Dusta Vrana)

Ulcer defined as any break in the continuity of the epithelial tissue. Venous Ulcer is also known as Stasis ulcer. It occurs due to chronic venous insufficiency caused by improper functioning of venous valves of the lower limb. Chronic and prolonged cases of varicose veins yield valve incompetence and stasis of blood resulting in venous hypertension allowing blood protein fibrinogen leakage causing fibrin to build up around vessels and prominence of vein preventing oxygen and nutrients from reaching the cell resulting in ulceration. The overall incidence rate is 0.76% in men and 1.42% in women. Over the age of 65, the prevalence increases to 4%. Among leg ulcers, 75% of ulcers are due to disorders of the venous system. The conservative treatment of venous ulcers includes standard wound dressing, wearing of support stockings and rest with legs elevated whenever possible along with diet and lifestyle modifications, debridement, sterile wound dressing, and at last life-saving aspects i.e., amputation. Wound care has become increasingly important given the rise of non-healing wounds and the morbidity associated with them. But the recurrence rate is quite high, the high recurrence along with severity of symptoms makes it a prominent subject of concern and interest in terms of finding more effective, more convenient, economical modalities of management. SuÅ›ruta Samhitā has exclusively mentioned the treatment regime for ‘Vraṇa’ as Jalaukāvacāraṇa. This study is planned to evaluate the effectiveness of Jalaukāvacāraṇa in wound healing in the patients of venous ulcer*.*

Each of the 20 patients will be treated with Jalaukāvacāraṇa on every 7th day and daily dressing with Jatyadi Taila will be done for 6 weeks along with oral medicaments i.e. Mañjiá¹£thādÄ« Kvātha 40ml twice a day on empty stomach and KaiÅ›ora Guggulu 3 tablet (each of 300mg) with warm water for 10 weeks. Patients may have to come to the hospital for follow up and investigations at every 15th day up to 4 weeks in O.P.D. to record the changes in sign and symptoms of disease.

The changes in the ulcer during the treatment will be observed and assessed by subjective and objective criteria. Subjective criteria includes pain, itching, odour and colour of the ulcer. Objective crieteria includes venous clinical severity score (VCSS) will be assessed before, 2nd, 4th, 6th  and 8th week of the treatment.