A Comparative Clinical Study to Evaluate the Efficacy of Tiladi Lepam and Its Gel Form in the Management of Dushta Vrana (Non-healing ulcer)

Background: Duṣṭa Vrana (chronic or infected wound) is a frequently encountered clinical condition marked by delayed healing, persistent inflammation, discharge, and malodor. Classical Ayurvedic formulations such as Tilādi Lepam are traditionally used for their Vraṇa Śodhana (wound cleansing) and Vraṇa Ropaṇa (wound healing) properties. Development of modern pharmaceutical dosage forms like gels may improve therapeutic efficacy and patient compliance. Aim: To evaluate and compare the clinical efficacy of classical Tilādi Lepam and its gel-based formulation in the management of Duṣṭa Vrana, using both Ayurvedic and biomedical clinical parameters. Materials and Methods: A randomized, open-label, comparative clinical study was conducted on 40 patients diagnosed with Duṣṭa Vrana. Participants were randomly assigned into two equal groups (n = 20 each). Group A received Tilādi Lepam in classical paste form, while Group B was treated with the gel formulation. Both groups underwent wound cleansing with Pañcavalkala Kvātha, followed by topical application and dressing once daily for 12 days. Clinical assessment included subjective symptoms (pain, itching, burning sensation, discharge, odor) and objective parameters (wound size, granulation tissue formation). Ethical clearance was obtained prior to the study. Results: Both treatment groups exhibited statistically significant improvements (p < 0.05) in all clinical parameters. However, Group B (gel formulation) demonstrated comparatively superior outcomes in pain relief, control of discharge and odor, enhancement of granulation tissue, and reduction in wound dimensions. Additionally, patients in the gel group reported better comfort, ease of application, and adherence to treatment. Conclusion: The gel formulation of Tilādi Lepam offers a more effective, user-friendly alternative for the management of Duṣṭa Vrana. This study highlights the potential for integrating traditional Ayurvedic formulations with modern pharmaceutical technology to optimize wound care outcomes.