A 63 years old male patient, suffered from injury on back which was ignored by family for 20 days. At present pt.is admitted in hospital since 15 days. Pt.is unable to recognise family members at present. Please suggest treatment for wound healing.



Dear Dr Pushpa * while injury any internal organs got damaged? * Why this unconsciousness? *What is about the vital data? If no vital organ damage, go choir for vrana prakshalana with kshara jala. It cures surely Thanks

vital word here refers to spinal cord

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It seems a complication of attempted PILONIDAL FISTULA

Right dr.

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Non healing ulcer

maine wound k cases me majoon aarad khurma ka istemaal kiya h aur healing speed badh jati hai sayh hi khadira rishth den....homeo ki calendula orally aur locallg dono use karen sath hi sicalcar orally den bahut achha resulg milega maine isme gangreen ka case kiya hai jo amputation k liye reffer tha

get wound culture. start sensitive antibiotics regular dressing give. if possible vaccume dressing for early result. correct anaemia and hypoproteinemia. after few days u can go for second stage

what about CBC / ppbs any comorbid condition like haemiplegia / bed ridden condition may be Bed sore infected. Ayurveda trifala / panchavalkal kwath - decoction prakshalan trifala guggal kaishor guggal jatyadi tail pichu shatadhaut ghrit + honey + haridra locally

There is very much information about the case, how the injury was caused, What other symptoms in the patient other than the the injury. Although cleaning injury with Calendula Q mixed in water should be tried with calendula 30 tds. Other remedy can be indicated if symptoms matches.

severe decubitus ulcers(Bed sore)

Start immediately with the following treatment : 1) Aarogyavardhini 60tab + Sutashekhara rasa 60tab + Triphala guggul 60tab + Gandhaka rasayan 60tab + Amrita guggul 60tab + Punarnava mandur 60tab + Guduchi satva 10gm mix all properly and give 500mg TDS with warm water. 2) Mahamanjishthadi kadha 4tsp BD with warm water. 3) Raktamokshana by Jalauka. 4) If patient is Daibetic than give Nishamalaki churna 3gm + Rasasindoor 250mg mix and give BD with warm water. 5) Cleaning and dressing should be done daily with all aseptic precautions. Apply Kumari + Madhu + Yavakshara + Jasad bhasma all in equal quantity and make lepa and apply over the wound and close the wound. Keep the area dry. Avoid kapha pitta vardhaka aahar vihar strictly.

Debridement is also needed...

Ulcers that heal within 12 weeks are usually classified as acute, and longer-lasting ones as chronic . A chronic wound is a wound that does not heal in an orderly set of stages and in a predictable amount of time the way most wounds do; wounds that do not heal within three months are often considered chronic. Chronic wounds seem to be detained in one or more of the phases of wound healing. For example, chronic wounds often remain in the inflammatory stage for too long.In acute wounds, there is a precise balance between production and degradation of molecules such as collagen; in chronic wounds this balance is lost and degradation plays too large a role. Chronic wounds may never heal or may take years to do so. These wounds cause patients severe emotional and physical stress and create a significant financial burden on patients and the whole healthcare system. Acute and chronic wounds are at opposite ends of a spectrum of wound healing types that progress toward being healed at different rates. Though treatment of the different chronic wound types varies slightly, appropriate treatment seeks to address the problems at the root of chronic wounds, including ischemia, bacterial load, and imbalance of proteases.Various methods exist to ameliorate these problems, including antibiotic and antibacterial use, debridement, irrigation, vacuum-assisted closure, warming, oxygenation, moist wound healing, removing mechanical stress, and adding cells or other materials to secrete or enhance levels of healing factors. Preventing and treating infection:- To lower the bacterial count in wounds, therapists may use topical antibiotics, which kill bacteria and can also help by keeping the wound environment moist, which is important for speeding the healing of chronic wounds.Some researchers have experimented with the use of tea tree oil, an antibacterial agent which also has anti-inflammatory effects.Disinfectants are contraindicated because they damage tissues and delay wound contraction.Further, they are rendered ineffective by organic matter in wounds like blood and exudate and are thus not useful in open wounds. A greater amount of exudate and necrotic tissue in a wound increases likelihood of infection by serving as a medium for bacterial growth away from the hosts defenses.Since bacteria thrive on dead tissue, wounds are often surgically debrided to remove the devitalized tissue.Debridement and drainage of wound fluid are an especially important part of the treatment for diabetic ulcers, which may create the need for amputation if infection gets out of control. Mechanical removal of bacteria and devitalized tissue is also the idea behind wound irrigation, which is accomplished using pulsed lavage. Removing necrotic or devitalzed tissue is also the aim of maggot therapy, the intentional introduction by a health care practitioner of live, disinfected maggots into non-healing wounds. Maggots dissolve only necrotic, infected tissue; disinfect the wound by killing bacteria; and stimulate wound healing. Maggot therapy has been shown to accelerate debridement of necrotic wounds and reduce the bacterial load of the wound, leading to earlier healing, reduced wound odor and less pain. The combination and interactions of these actions make maggots an extremely potent tool in chronic wound care. Negative pressure wound therapy (NPWT) is a treatment that improves ischemic tissues and removes wound fluid used by bacteria.This therapy, also known as vacuum-assisted closure, reduces swelling in tissues, which brings more blood and nutrients to the area, as does the negative pressure itself. The treatment also decompresses tissues and alters the shape of cells, causes them to express different mRNAs and to proliferate and produce ECM molecules. Treating trauma and painful wounds :- Persistent chronic pain associated with non-healing wounds is caused by tissue (nociceptive) or nerve (neuropathic) damage and is influenced by dressing changes and chronic inflammation. Chronic wounds take a long time to heal and patients can suffer from chronic wounds for many years.Chronic wound healing may be compromised by coexisting underlying conditions, such as venous valve backflow, peripheral vascular disease, uncontrolled edema and diabetes mellitus. If wound pain is not assessed and documented it may be ignored and/or not addressed properly. It is important to remember that increased wound pain may be an indicator of wound complications that need treatment, and therefore practitioners must constantly reassess the wound as well as the associated pain.

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