Management of a Surgical Site Infection using Herbal Fumigation (Vrana Dhoopan) and Ayurvedic Interventions: A Case Report

Abstract INTRODUCTION: Infection occurring within 30 days after the operation if no implant is left in place or within 1 year if an implant is in place is described as a surgical site infection. It clinically presents with delayed wound healing, pain, profuse discharge, and foul smell from the wound site. In Ayurveda, surgical-infected wounds can be correlated with Shastrakrita Dushta Vrana (surgical site-infected wound). Dhoopan Karma (~herbal fumigation) is one of the effective treatment modalities mentioned among Shashtiupakrama (60 procedures for wound management) for Dushta Vrana (~infected wound). Hence, the case study presents a surgical site-infected wound that has been managed with herbal fumigation along with Ayurvedic oral medications. PATIENT INFORMATION: An 18-year-old female presented with persistent pain, itching, foul smell, and profuse discharge from a post-surgical wound following a previous surgical intervention for a pilonidal sinus for 3 months. There was no history of fever or any signs of systemic infection. The wound measured approximately 5 cm × 3 cm × 2 cm in size and lacked proper granulation tissue. Based on clinical findings, it was diagnosed as a non-healing surgical site infection. MATERIALS AND METHODS: The patient was treated with herbal fumigation with Guggul ( Commiphora wightii Arnott ), Manjishta ( Rubia cordifolia Linn ), Rala ( Shorea robusta Gaertner f ), Nimba ( Azadirachta indica A. Juss ), and Goghrita (clarified cow butter), followed by sterile dressing once in the morning hours and other during the evening hours for 10 days along with oral administration of Triphala Guggul (500 mg) 2 tablets, Samshamani Vati ( 140 mg ) 5 tablets, and Gandhak Rasayan Vati ( 330 mg ) 2 tablets twice a day internally for 15 days. RESULTS: After ten days of herbal fumigation, sterile dressing, and Ayurvedic oral medications, the patient’s symptoms, including pain, itching, purulent discharge, and foul odor from the natal cleft wound, had significantly reduced. On the follow-up, after 15 days, the wound had healed completely without any complications. CONCLUSION: Based on this case study, it can be concluded that the combination of herbal fumigation along with sterile dressing and oral Ayurvedic drugs can be used as an effective treatment modality for managing infected surgical site wounds. A comprehensive wound care protocol incorporating herbal fumigation ( Vrana Dhoopan ) and Ayurvedic oral interventions presents a potential treatment approach for infected wounds. The therapeutic efficacy of this integrative approach can be further validated through well-designed clinical trials.