Jalaukāvacaraṇa (Hirudo therapy) in the management of necrosed index finger due to crush injury

D. Sambhaji, Komang Sudarmi
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Abstract

Necrosis of tissue has become the challenging case, considering the difficulties of its management to bring back the normalcy of dead tissue. Treatment choice in surgery ends up with amputation of the affected part which leads to depression to a patient. In Ayurveda, posttraumatic necrosis can be correlated with picchita vraṇa (crushed injury) which is included under āgantuja vraṇa (traumatic injury). In this case report, an interesting case of posttraumatic necrotic changes of the right index finger was presented to us at the Outpatient Department of Ayurved Research Hospital. There was symptom of aggravated pain along with gradual discoloration of the tip of the index finger to a necrotic condition. Naturally, such cases have a very poor prognosis. Considering the pathological changes in this case, jalaukāvacaraṇa (Hirudo therapy) procedure has been taken up for the management. In the 1st week, three leeches were applied after every 3 days, and later on, after every 7 days, further three sittings of leech application were done. Leech absorbed impure blood which results in neovascularization and reconstruction of the necrotic tissue. Antiplatelet and antithrombin action of hirudin present in saliva of leech recanalizes the thrombus or clot at the injured part. The patient was cured completely and survived the finger from amputation with jalaukāvacaraṇa (Hirudo therapy).
Jalaukāvacaraṇa(喜疗妥疗法)治疗因挤压伤坏死的食指
考虑到恢复死亡组织正常的管理困难,组织坏死已成为一个具有挑战性的案例。手术中的治疗选择最终会导致患者患部截肢,从而导致抑郁。在阿育吠陀中,创伤后坏死可与皮奇托vra相关ṇa(挤压伤),包括在āgantuja vra下ṇa(创伤性损伤)。在本病例报告中,阿育吠陀研究医院门诊部向我们介绍了一个有趣的右食指创伤后坏死变化病例。伴随着食指指尖逐渐变色坏死,出现了疼痛加剧的症状。当然,这类病例的预后非常差。考虑到本例的病理变化,jalaukāvacaraṇ已经采用了(喜疗妥疗法)程序进行管理。在第1周,每3天施用三次水蛭,随后,每7天再施用三次。水蛭吸收了不纯净的血液,导致坏死组织的新生血管形成和重建。水蛭唾液中水蛭素的抗血小板和抗凝血酶作用可使受伤部位的血栓或凝块再通。患者完全治愈,并用jalaukāvacara从截肢手术中幸存下来ṇa(喜疗妥疗法)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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