Standalone Ayurvedic management of chronic nonhealing diabetic foot ulcers: A retrospective case series

Abstract: Diabetic Foot Ulcers (DFUs) are chronic complications of diabetes, often leading to amputation and impaired quality of life. Conventional treatments show variable efficacy. This case series evaluates the role of Ayurvedic therapies in DFU management. Three patients (aged 71, 68 and 48 years, respectively) with neuropathic DFUs, including osteomyelitis and multidrug-resistant infected ulcers, underwent treatment with a comprehensive Ayurvedic protocol comprising Jatyadi taila/ghrita for Vrana shodhana (~wound cleansing) and Vrana ropana (~wound healing); Aragwadhadi, Patolakaturohinyadi, Nimbadi, Guduchyadi, Punarnavadi, Kalyanaka and Mulakadi kashaya for Dushta vrana (~putrefied wound), Krimighna (~anthelmintic), Vishaghna (~anti-toxic), and Shothahara (~anti-inflammatory) actions; Mahamanjishthadi, Katakakhadiradi, Guggulutiktaka, Sahacharadi , and Rasnapanchaka kashaya to address the associated Prameha (~Diabetes mellitus), pain, edema, improve local blood circulation, prevent further progression of the wound to Asthidhatu (~bone tissue), Vata -related dysfunction, and tissue repair; Kaishora guggulu, Chandraprabha vati, Shiva gulika , and Vettumaran gulika for Prameha, Vrana , chronic inflammation, and Rasayana (~rejuvenation) support; Shadadharana, Nimbadi, Amrita , and Triphaladi churna for Krimighna, Vishaghna , and metabolic correction; and Guggulutiktaka ghrita, Kalyanaka ghrita , and Madhusnuhi rasayana for chronic wound healing, tissue nourishment, and Rasayana therapy. A total of four wounds achieved complete healing within 180–280 days, with marked reduction in inflammation, healthy granulation, and complete epithelialization without surgical intervention. These findings suggest that individualized Ayurvedic management may offer a promising adjunctive approach for complex DFUs. Further randomized controlled trials are warranted to validate these findings.