AIM AND
OBJECTIVES
1.
To evaluate the efficacy of Madhuyashti ghrita local application in the management of Sadyovrana.
2.
To evaluate the efficacy of Panchavalkala Ghrita local application in the management of Sadyovrana.
3.
To compare the effectiveness of Madhuyashti ghrita with
Panchavalkala Ghrita local
application in the management of Sadyovrana.
INTRODUCTION
Skin injuries across the body continue to
disrupt everyday life for millions of patients and result in prolonged hospital
stays, infection, and death. Advances in wound healing devices have improved
clinical practice but have mainly focused on treating macroscale healing versus
underlying microscale pathophysiology. Consensus is lacking on optimal
treatment strategies using a spectrum of wound healing products, which has
motivated the design of new therapies. We summarize advances in the development
of novel drug, biologic products, and biomaterial therapies for wound healing
for marketed therapies and those in clinical trials. We also share perspectives
for successful and accelerated translation of novel integrated therapies for
wound healing
Vrana [1,2] is the commonest painful condition that
every human being suffers in their life. Ayurveda
texts have given prime importance to vrana
and described the vrana in thoughtful
manner. Wound healing procedures described by Sushruta still hold significant
place today as well. Faster the wound healing, faster is the recovery of the
patient, enabling him to resume his daily routine.
Madhuyashti ghrita3 and Panchavalkala ghrita4 are
very much appreciated as wound healer. Madhuyashti ghrita is known to
have good healing properties while Panchavalkala
ghrita has a good grahi, shodhana and
ropana effect. This study is planned to see the healing property of both
drugs and also to give cosmetically neat and minimal scar. These two medicines
are easily available, cost effective and can be tried on OPD basis.
SOURCE OF DATA Patients
diagnosed as Sadyo Vrana will be
selected from Out Patient and In Patient Departments of P.G Studies in Shalya
Tantra, Sri Dharmasthala Manjunatheshwara college of Ayurveda & hospital,
Hassan.
SAMPLING
TECHNIQUE: Randomize
sampling
SAMPLE SIZE: 40
METHODOLOGY
Group
A- Taken as Standard group
1.
Poorva
Karma – Cleaning of the wound and surrounding with normal
saline and sterile gauze.
2.
Pradhana Karma –Madhuyashti
Ghrita
application twice in a day for 7 days.
3. Paschata Karma – bandaging will by
done by using sterile pad and roller and Advise the subject to maintain
the hygiene.
4. Assessment will be done before
treatment and on 7th day of treatment
5. Follow up: On 14th day and
21st day.
Group B Taken as Trial group
1.
Poorva karma- Cleaning of the wound and surrounding with
normal saline and sterile gauze.
2. Pradhana karma –Panchavalkala ghrita application twice in a day for 7 days.
3. Paschata Karma – bandaging will by
done by using sterile pad and roller and Advise the subject to maintain
the hygiene.
4. Assessment will be done before
treatment and on 7th day of treatment.
5. Follow up: On 14th day and
21st days
MATERIAL AND METHOD OF PREPARATION
Preparation
of Madhuyashti Ghrita will be
procured by Sri Dharmasthala Manjunatheshwara College of Ayurveda &
Hospital, Hassan pharmacy
METHOD OF PREPARATION OF PANCHAVALKALA GHRITA:
Panchavalkala kwatha 16 parts, Panchavalkala Kalka 1 part, Goghrita 4 parts. Pachavalkala kwatha is prepared primarily, followed by adding Drava Dravya to Pachavalkala churna
Kalka is prepared. Later it is mixed with the Sneha and Paka is done
over Agni till the fumes stops & water content is evaporated and Samyak Gritha Paaka Lakshanas are
obtained thus Panchavalkala Ghrita is
obtained.
DIAGNOSTIC CRITERIA:
Based on signs & symptoms of Sadyovrana.
1.
Vrana kala (time period of vrana) less
than 7 days.
2.
Shoola (Pain at wound site)
3.
Daha (Burning sensation over
wound site)
4.
Vrana parimana (wound size)<36 sq cm as per
bates & Jansen assessment criteria
INCLUSION CRITERIA:
1.
• Patients will be select from irrespective
of gender, age, religion and occupation. etc
2.
Patients having any one of classical
features of Ghrushta vrana, Chinna vrana, Kshata vrana
3.
wound size <36 sq cm as per bates & Jansen
assessment criteria
EXCLUSION
CRITERIA:
1.
Bhinna vrana ,Viddha
vrana,Picchit vrana
2.
Patients suffering from leprosy, syphilis,
Tubercular malignant wound, osteomyelitis, varicose veins
3.
Dushta Vrana.
4.
Traumatic wounds with severe complications like
fracture, dislocation, severe hemorrhage.
5.
Patients with other systemic illness like uncontrolled diabetes mellitus
(HbA1c> 8%), Human Immunodeficiency Virus and Hepatitis B positive.
ASSESSMENT
CRITERIA:
ASSESSMENT
CRITERIA: (BATES & JANSEN ASSESMENT CRETERIA)
|
Sl no
|
Item
|
Assessment
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Day 1
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Day 2
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Day 3
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Day 4
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Day 5
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Day 6
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Day 7
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1.
|
Pain
(Vedana)
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0 - No pain
1- mild pain (1-3 in NPRS)
2 - moderate (4-6 in NPRS)
3 - severe (7-10 in NPRS)
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2
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Vrana Akruthi
(Size)
|
1- Length x width <4 sq cm
2- Length x width 4--<16 sq cm
3- Length x width 16.1--<36 sq cm
4-Length x width 36.1--<80 sq cm
5- Length x width >80 sq cm
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3.
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Vrana oshta (Edges)
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1- Indistinct, diffuse, none clearly visible
2- Distinct, outline clearly visible, attached, even with wound
base
3- Well-defined, not attached to wound base
4- Well-defined, not attached to base, rolled under, thickened
5- Well-defined, fibrotic, scarred or hyperkeratotic
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4.
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Mamsaankura (Granulation Tissue)
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1- Skin intact or partial thickness wound
2- Bright, beefy red; 75% to 100% of wound filled &/or tissue
overgrowth
3- Bright, beefy red; < 75% & > 25% of wound filled
4- Pink, &/or dull, dusky red &/or fills < 25% of wound
5- No granulation tissue present
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5.
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Twacha
(skin color
surrounding the wound)
|
1- Pink or normal for
ethnic group
2 -Bright red
&/or blanches to touch
3 -White or grey
pallor or hypopigmented
4 -Dark red or purple
&/or non-blanchable
5 -Black or
hyperpigmented
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6.
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Epithelization
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1 = 100% wound covered, surface intact
2 = 75% to <100% wound covered &/or epithelial
tissue extends > 0.5cm into wound bed.
3 = 50% to<75% wound covered &/or epithelial
tissue extends to <0.5cm into wound
bed
4 = 25% to< 50% wound covered
5 = < 25% wound covered
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