Multimodal Management of Chronic Venous Stasis Ulcer (Dushta Vrana): A Clinical Case Report

Venous stasis ulcers represent a severe manifestation of chronic venous insufficiency (CVI), posing a significant clinical and economic burden due to high recurrence rates and prolonged healing times. In Ayurvedic pathology, this condition closely correlates with Siragranthi (varicosity) progressing into a Dushta Vrana (chronic, non-healing ulcer). This comprehensive case report details the integrative management of a 28-year-old male presenting with a recalcitrant venous stasis ulcer on the left lower extremity. A multimodal protocol was initiated, combining systemic Ayurvedic pharmacotherapy (Mahamanjisthadi Kadha, Arogyavardhini Vati), localized parasurgical intervention (Raktamokshana), topical botanical wound care (Triphala and Neem Prakshalana, Jatyadi Taila), modern antiseptics (Povidone-iodine), and postural hemodynamics (Viparita Karani). Over the treatment course, the regimen achieved complete autolytic debridement, rapid attenuation of stasis dermatitis, and full re-epithelialization of the ulcer bed. This study underscores the clinical efficacy of bridging Ayurvedic surgical and pharmacological principles with modern diagnostic and wound care parameters.