Abstract

Burn wounds in the perianal region are difficult to treat because the area is constantly exposed to stool contamination, has complex anatomy, and is at high risk of infection. In modern medicine, such wounds often need regular dressing, strict hygiene. Ayurveda provides alternative treatment options that may help to reduce chances of infection and healing process. In this case report, a 54 year old male having an Itartha Dagdha Vrana (accidental burn wound) in the perianal region caused by a hot water sitz bath. The patient had a second-degree burn with pain, discharge, unhealthy granulation tissue, and difficulty sitting and passing stool. The treatment was done by daily wound hugineand local application of Katupila Ghrita, antibiotic and analgesic were given for 5 days. Triphala gugulu (500 mg) was given TDS after meal, Erand bhrishta haritaki churna (5mg) was given HS and Panchvalkal kwath (Q.S.) was given for sitz bath daily. Pathya Apathya was advice. Marked improvement was noted within 5 days, with reduction in slough, discharge, local heat, and tenderness. By the 11th day, healthy granulation tissue had formed, and complete healing occurred by the 26th day with minimal scarring. The healing effect of Katupila Ghrita may be due to its Lekhana, Stambhana, antiinflammatory, antimicrobial, and antioxidant actions. This case suggests that Katupila Ghrita can be an effective, cost effective option for treating perianal burn wounds.

• 1.   Bordes J., Le Floch R., Bourdais L., et al. “Perineal burn care: French working group recommendations.” Burns. 2014; 40(4): 655-63.
• 2.   Michielsen D.P., Lafaire C. “Management of genital burns: A review.” Int J Urol. 2010; 17: 755-8.
• 3.   Keshava A., Renwick A., Stewart P., Pilley A. “A non-surgical device for faecal diversion in the management of perineal burns.” Dis Colon Rectum. 2007; 50(7): 1017-22.
• 4.   Bordes J., Le Floch R., Bourdais L., Bru N., Duteille F., Planchon B., et al. Perineal burn care: French working group recommendations. Burns. 2014; 40(4): 655-663.
• 5.   Price C.E., Cox S., Rode H. The use of diverting colostomies in paediatric peri-anal burns: Experience in 45 patients. S Afr J Surg. 2013; 51(3): 102-105.
• 6.   Merchant N., Boudana D., Willoughby L., Cartotto R. Management of adult patients with buttock and perineal burns: The Ross Tilley Burn Centre experience. J Trauma Acute Care Surg. 2014; 77(4): 640-648.
• 7.   Boccara D., Chaouat M., Serror K., Mimoun M. Specificities of management of perineal burns. J Burn Care Res. 2024; 45(4): 1032-1040.
• 8.   Baba P.U.F., et al. Perineal burns: Epidemiology, severity factors, management issues and outcome. Burns Open. 2022; 6: 82-91.
• 9.   Church D., Elsayed S., Reid O., Winston B., Lindsay R. Burn wound infections. Clin Microbiol Rev. 2006; 19(2): 403-34.
• 10.   Maitz J.A. Burn wound infections: microbiome and novel approaches. Burns. 2023; 49(2): 548-562.
• 11.   Merchant N., Boudana D., Willoughby L., Cartotto R. Management of adult patients with buttock and perineal burns: The Ross Tilley Burn Centre experience. J Trauma Acute Care Surg. 2014; 77(4): 640-648.
• 12.   Anagha T.S., Sweta K.M., Surendranath D. A critical study on burn injury (Dagda Vrana) with special reference to Sushruta Samhita. J Ayurveda Integr Med Sci. 2022 Oct 2; 7(8): 86-92
• 13.   Kasar S., Dhule M., Jaiswal S. Concept of Dagdhavrana in Ayurveda: A review. Tathapi. 2020; 19(56): 76-80.
• 14.   Abraham J.P., Nelson-Cheeseman B.B., Bourdon R.T. Review of the initial treatment and avoidance of scald injuries. World J Dermatol. 2017; 6(2): 17-26.
• 15.   Lee A., Wang Y., Nadarajah C., Lipner S.R. Double-covered skin areas are at high-risk for scald and chemical burns in a crosssectional analysis of NEISS 2000–2018. Indian
• 16.   Alnasser K., Al-Sohaibani M.A., Alharthy A, Alasmari K., Alshammari H. The efficacy of sitz baths as compared to lateral internal sphincterotomy in patients with anal fissures. Int Surg J. 2022; 9(4): 2131–2135.
• 17.   Ajmeer A.S., Dudhamal T.S., Gupta S.K., Mahanta V. Topical application of Katupila (Securinega leucopyrus) in Dushta Vrana (chronic wound) showing excellent healing
• 18.   Gopal T.K., Sheela T., Reddy L.S.K., Gopal T.K., Chamundeeswari D., Uma M. In-vitro antioxidant activity of chloroform extract of aerial parts of Securinega leucopyrus (Willd.) Muell. Der Pharmacia Lettre. 2010; 2(6): 252-256.
• 19.   Yi-Shen Z., Shuai S., FitzGerald R. Mung bean proteins and peptides: Nutritional, functional and bioactive properties. Food & Nutrition Research. 2018; 62: 1290.
• 20.   Udwadia T.E. Ghee and honey dressing for infected wounds. Indian Journal of Surgery. 2011; 73(4): 278-283. doi:10.1007/s12262-011-0240-7.
• 21.   Shaikh S., Ukande M., Murthy K., Shete R., Solunke R.S. Traditional Remedies for Wound Healing: A Review. Journal of Drug Delivery & Therapeutics. 2021; 11(5-S): 152-158.
• 22.   Jurenka J.S. Therapeutic applications of pomegranate (Punica granatum L.): A review. Alternative Medicine Review. 2008; 13(2): 128–144. PMID: 18590349.
• 23.   Aravind G., Bhowmik D., Duraivel S., Harish G. Traditional and medicinal uses of Carica papaya. Journal of Medicinal Plants Studies. 2013; 1(1): 7–15.
• 24.   Someya S., Yoshiki Y., Okubo K. Antioxidant compounds from bananas (Musa cavendish). Food Chemistry. 2002; 79(3): 351–354. doi:10.1016/S0308-8146(02)00186-3.
• 25.   Shastri A.D., editor. Sushruta Samhita of Maharshi Sushruta, Sutra Sthana, Chapter 46 (Annapanavidhi Adhyaya). Varanasi: Chaukhambha Sanskrit Sansthan; 2018. pp.
• 26.   Eswaran S., Muir J., Chey W.D. Fiber and functional gastrointestinal disorders. Am J Gastroenterol. 2013; 108(5): 718–727.
• 27.   Leaper D.J., Edmiston C.E. World Health Organization: prevention of surgical site infection. J Hosp Infect. 2017; 95(2): 135–136.
• 28.   Booth F.W., Roberts C.K., Laye M.J. Lack of exercise is a major cause of chronic diseases. Compr Physiol. 2012; 2(2): 1143–1211.
• 29.   Sharma R.K., Goel A., Singh V. The management of perineal wounds. Ann R Coll Surg Engl. 2012; 94(6): 417-23.
• 30.   Telles S., Pathak S., Kumar A., Mishra P., Acharya B. Ayurvedic Doshas as Predictors of Sleep Quality. Med Sci Monit. 2015; 21: 2283-8.

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