Pain management and wound bed Preparation in chonic non healing wound over heel by Leech Therapyy-A Case Study
Abstract
In Ayurveda, Chonic non healing wound can be correlated to Dushtavrana which has foul smell, putrefied pus along with blood and cavity, present since long time and has bad odor.
According to T.I.M.E. principle of wound management, Leech therapy stands as biotherapy for wound debridement. Vis a vis it has anti-coagulant, anti-phlogistic, antibacterial and anesthetic properties which relieve local inflammation, enhances microcirculation thereby providing nutrition to the affected tissues. Thus it facilitates formation of healthy granulation tissue and wound bed preparation. A case study is presented in which a female of 65 years of age with chronic non healing wound on right heel, presented to our OPD. Prima facie it resembled a malignant ulcer due to severe pain and soft tissue deformity on the heel. But on HPE, it was found to be benign. According to T.I.M.E principle, this dushtavrana was subjected to debridement under LA, daily dry dressing and leech therapy for 15 days. On day 5 only, patient got 70% pain relief (analyzed by VAS scale) and wound bed preparation assessed by various subjective criteria. When the wound bed was prepared, skin grafting was done on right heel.
15 days of post-operative stay in IPD and repeated 3 days follow up for 2 weeks, it was found that the graft was accepted. It can be stated that Leech therapy plays a commendable role in pain management and wound bed preparation in chronic non healing wound.
Keyword: Chronic non healing wound, Pain, T.I.M.E., Leech therapy, Wound bed, Skin grafting.
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References
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