LEECH APPLICATION IN VARICOSE ULCER: A SINGLE CASE STUDY

Dr. Deeksha Joshi*, Dr. Sunil Kumar Gupta

ABSTRACT

Introduction: Varicose ulcers (venous insufficiency ulcers) are wounds that occur due to improper functioning of venous valves.[1] 70% to 90% of leg ulcers are venous in origin.[2] Venous ulcers can be painful and typically form along the medial distal leg. If not treated properly, the ulcer may get infected leading to cellulites or gangrene and eventually lead to amputation of the limb. Ayurveda also mentioned about chronic ulcers (Dustavrana). In Sushrut Samhita, we get the most scientific description of wound and its management. He has given utmost importance to bloodletting and considered jalaukavcharan (leep application), as the most unique and effective method of bloodletting even in infected wounds and abscesses. If the conservative management like compression stocking, foot elevation, antibiotics and regular dressing of wound fail, then surgical treatment like skin grafting, sclerotherapy, laser ablation and other surgical correction were practiced. However, recurrence of venous ulcers is common, ranging from 54 to 78%. Material and method: A male patient 56 years old from jwalapur, Haridwar, Uttarakhand approached Shalya OPD of Gurukul Ayurvedic College and Hospital, Haridwar with the complain of an ulcer over the right lower leg with pain and swelling since 6 months. Pain was very intense and whole foot was swollen. He was suffering from varicose vein in both the legs since 2 years. On examination medial-posterior aspect of right ankle joint an ulcer was noticed. The ulcer was characteristically covered by unhealthy granulation tissue with slough, pus and foul smell. Color Doppler revealed few tortuous superficial venous channels in right lower limb in the medial and posterior aspect of below knee. Case was diagnosed as a chronic unhealed varicose ulcer. After proper investigation the patient was planned for Jalaukavacharana to evaluate the efficacy of Jalaukavacharan. Eight sittings of Jalaukavacharna after every seven days were performed along with oral medications and results were observed. Observation and result: The patient got relief in all symptoms including Pain, swelling, unhealthy granulation tissue with slough, pus and foul smell. Conclusion: Ayurvedic conservative management provides relief in symptoms as well as improves quality of life. Jalaukavacharna along with conservative management presents as a good alternative for patients seeking non-surgical options for management of varicose ulcer.

Keywords: Jaloukavacharana, Dustavrana, Sirajagranthi, leech, chronic wound.