Effect of Thumari Malahara in The Management of Post-debridement Wound of Fournier’s Gangrene

Abstract

Background: Despite improvements in surgical techniques, suture materials, and peri-operative care, acute wound failure or dehiscence remains a dreaded surgical complication. Factors contributing to wound failure include inadequate closure, local factors like infection, advanced age, obesity, malnutrition, and local surgical site infection or hematoma. Case details: A 59-year-old patient referred from Civil hospital to Shalya Tantra OPD seeking management of post debridement wound, on 15^th day after secondary suture on debrided wound of Fournier’s Gangrene.

Material and Methods: Sutures from the dehisced wound (8×4×2 cm³) were removed and wound management was done by daily dressing with Normal Saline and packed with Thumari Malahara until complete healing. Triphala Guggulu 1gram three times daily and Isabgol husk 2 tablespoonsful at bedtime with lukewarm water was given for one month. The assessment was done on every 7^th day on subjective criteria like Varna (Colour of margin & surrounding skin), Srava (Discharge), Vedana (Pain) and granulation tissue and objective criteria as Unit Healing Time (UHT).

 Results and discussion: Unit healing time was 0.437 days/cm³ with significant decrease in amount of discharge, pain etc. The wound healed completely within 4 weeks of treatment. During follow up for 60 days, no recurrence was noticed. Thumari known as Securinega leucopyrus is a potential drug for wound healing. Thumari in a Malahara formulation further aids in wound healing by maintaining moist environment in wound and penetrating drugs to deeper tissue.

Conclusion: This case demonstrates the significant wound healing effect of Thumari Malahara along with adjuvant Ayurveda medicines in the management of post debridement wound of Fournier’s Gangrene.