INTEGRATIVE MANAGEMENT OF DUSHTA VRANA (NON HEALING DIABETIC FOOT ULCER WITH OSTEOMYELITIS) – A CASE REPORT

Abstract

Background - Neuropathy, ischemia, and infection are the classical triad of Diabetic foot. Studies on DM states that 15% of patients ends up with Diabetic foot ulcers (DFU)during their lifetime among that 15 – 20% undergoes amputation due to osteomyelitis. Acharya sushruta has mentioned shasti upakrama (60 treatment procedures) for management of chronic non healing ulcer which are major guidelines for wound management. Objective – Integrative management of diabetic foot ulcer with Osteomyelitis Materials and Methods – Here, a case of diabetic foot ulcer occurred due to infection and complicated with osteomyelitis of calcaneal bone was managed with integrated approach i.e initially with empirical Antibiotics, Insulin therapy as he was in septicemia followed with Ayurveda i.e chedhana (Surgical debridement), oral medicines and local wound care for a period of 5 months. The pus culture and sensitivity reported that he was resistant to maximum antibiotics which were evident due to recurrent infection and hospitalization. The wound was showing good signs of healing so the Ayurveda management was continued. At the end of five month conservative management infection was not controlled so amputation was opted as life saving procedure. Conclusion – Integrative management helped in proper assessment and treatment of diabetic foot ulcer with osteomyelitis.