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 15th 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 7th 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.