A systemic review on vrana and it’s management

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Journal name: World Journal of Pharmaceutical Research
Original article title: A systemic review on vrana and it’s management
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Author:

Dr. Sombir Sheoran, Dr. Bushra Khanam, Dr. Rahul Sher Khane, Dr. Vyasadeva Mahanta, Dr. Sanjay Kumar Gupta


World Journal of Pharmaceutical Research:

(An ISO 9001:2015 Certified International Journal)

Full text available for: A systemic review on vrana and it’s management

Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research

Doi: 10.20959/wjpr201912-16021

Copyright (license): WJPR: All rights reserved


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Summary of article contents:

Introduction

The article discusses "Vrana," a term in Ayurveda denoting wounds or ulcers characterized by the discontinuity or break in the body's epithelium. Chronic wounds are prevalent, affecting 1-2% of the population in developed countries, causing substantial physical, emotional, and financial burdens for patients and their families. A detailed understanding of wound management is essential, incorporating both ancient Ayurvedic practices and modern medical knowledge. The wisdom of ancient texts, particularly the work of Acharyas like Sushruta, sheds light on various types of wounds and their management through Ayurveda.

Etiopathogenesis of Vrana

One important concept presented is the etiopathogenesis of Vrana, which is categorized into two distinct factors: extrinsic (Agantuja) and intrinsic (Nija). The extrinsic factors include various accidental injuries such as cuts, bruises, and other traumas caused by sharp or blunt instruments. These factors typically lead to wounds without initial imbalances in bodily doshasVata, Pitta, and Kapha—but later may develop into disturbances. In contrast, intrinsic factors are associated with the body's inherent imbalances, leading to chronic conditions like ulcers. The article emphasizes that understanding these factors is crucial for targeted and effective management of wounds.

Classification of Vrana

Another significant concept involves the classification of Vrana, as outlined by ancient texts. Sushruta and other practitioners categorize wounds based on various criteria, including the nature of the dosha involved—be it Vataja, Pittaja, or Kaphaja—and whether the wound is Shuddha (clean) or Dushta (chronic). This classification system aids in diagnosis and treatment by allowing practitioners to tailor approaches based on the wound's characteristics and underlying doshic imbalances. Detailed characteristics, including the color and texture of the wound, provide insights into the appropriate therapeutic measures required for management.

Management Principles of Vrana

The article further elaborates on Sushruta’s management principles for Vrana, which encompass three main stages: Purvakarma (pre-operative preparation), Pradhanakarma (the surgical procedure), and Paschatkarma (post-operative care). Each stage involves specific measures aimed at ensuring proper healing and minimizing complications. Management techniques range from local applications to facilitate healing to surgical interventions that address infected or chronic wounds. The sixty methods of wound management prescribed by Sushruta incorporate both dietary considerations and therapeutic measures to address the emotional and physical needs of the patient recovering from wounds.

Conclusion

In conclusion, the concept of Vrana in Ayurveda presents a comprehensive framework for understanding and managing wounds. By recognizing the etiological factors, classifications, and treatment principles, practitioners can adopt a holistic approach to wound care that integrates ancient wisdom with modern medical practices. The emphasis on doshic balance and therapeutic individuality not only enhances healing processes but also improves the quality of life for patients suffering from chronic wounds. This systemic review highlights the importance of combining ancient Ayurvedic insights with contemporary understanding to advance wound management practices effectively.

FAQ section (important questions/answers):

What is the definition of 'Vrana' in Ayurveda?

In Ayurveda, 'Vrana' refers to a wound or injury that disrupts the body's tissues, leading to discoloration and a break in continuity of the skin or mucous membrane. It can be caused by various factors and may result in chronic conditions if not managed properly.

What are the main etiological factors of 'Vrana'?

The etiological factors of 'Vrana' are divided into extrinsic ('Agantuj') factors like injuries and intrinsic ('Nija') factors linked to imbalance in 'Doshas', 'Dhatus', and 'Mala', affecting the body's physiological functions.

How is the pathology of 'Vrana' explained in Ayurveda?

The pathology of 'Vrana' follows a progression that includes factors such as 'Nidana', 'Dosha', and 'Dushya'. 'Sushruta' described six stages of disease occurrence, indicating possible symptoms and treatment approaches throughout the progression.

What are the classifications of 'Vrana' according to Ayurvedic scholars?

According to 'Sushruta', 'Charaka', and 'Vagbhata', 'Vrana' can be classified as 'Shuddha' (pure), 'Dushta' (impure), 'Nija' (internal), and 'Agantuja' (external), with each type having different characteristics and treatment protocols.

What is the significance of 'Ropana' in wound management?

'Ropana' refers to the healing process of a wound. In Ayurveda, achieving proper 'Ropana' involves using local applications, maintaining a clean environment, and addressingvitiated 'Doshas' to promote effective and timely healing.

What are some common management practices for 'Vrana'?

Management of 'Vrana' involves a series of treatments including 'Shodhana' (purification), 'Ropana' (healing), and specific measures such as medicated applications, nutritional guidance, and addressing underlying 'Dosha' imbalances for better recovery.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “A systemic review on vrana and it’s management”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Vrana:
In Ayurveda, 'Vrana' refers to a wound or ulcer that occurs due to injury or disease, leading to disruption of tissue integrity. It signifies not just physical damage but also relates to the underlying imbalance of the body's doshas. Proper care is vital for healing.

2) Dosha (Dosa):
The term 'Dosha' represents the three fundamental bodily humors in Ayurveda: Vata, Pitta, and Kapha. They govern physiological processes and health. An imbalance among these doshas leads to various diseases, emphasizing their role in maintaining health and healing wounds like Vrana.

3) Disease:
'Diseases' encompass health conditions characterized by disturbances in bodily functions or structures. In Ayurveda, diseases are treated based on dosha imbalances, emphasizing holistic management strategies aimed at restoring balance and promoting healing.

4) Dushta (Dusta):
The term 'Dushta' signifies a state of deterioration or corruption within the context of wounds or ulcers, indicating a chronic or infected condition. It emphasizes the importance of timely intervention and management in Ayurveda to prevent complications from worsening conditions.

5) Table:
In the text, 'Table' refers to organized data presenting classifications of Vrana, doshas, and other related concepts. It aids in understanding complex Ayurvedic theories and classifications thoroughly, allowing practitioners to identify and manage wounds according to their characteristics more efficiently.

6) Shodhana (Sodhana):
'Shodhana' pertains to the purification process aimed at detoxifying the body of vitiated doshas and impurities. In wound management, it is fundamental to cleanse wounds from toxins, promoting a conducive healing environment by removing unwanted substances that hinder recovery.

7) Pitta:
'Pitta' is one of the three doshas in Ayurveda associated with heat, metabolism, and transformation. It plays a crucial role in inflammation and tissue healing processes. In the context of Vrana, a Pitta imbalance can lead to excessive heat and infection in wounds.

8) Shrava (Srava):
The term 'Srava' refers to exudate or discharge from wounds, which is an important diagnostic feature in Ayurveda. The nature of Srava, whether purulent or serous, assists in assessing the wound's condition and guides further treatment and management decisions.

9) Pain:
'Pain' is a symptom that reflects the body’s response to injury or disease. In Ayurveda, pain is closely associated with dosha imbalances, particularly Vata and Pitta. Understanding pain helps practitioners to identify underlying issues and tailor treatments that alleviate discomfort.

10) Agantuja (Agantu-ja):
'Agantuja' describes wounds or conditions caused by external factors, such as trauma or injury. It contrasts with 'Nija' conditions, emphasizing the importance of understanding the etiology of wounds for appropriate management strategies within the Ayurvedic framework.

11) Vata:
'Vata' is the dosha associated with air and ethereal qualities, governing movement in the body. Disruption in Vata can lead to various health issues, including pain and chronic wounds. Its management is crucial in treating conditions related to Vrana.

12) Dushtavrana (Dustavrana, Dusta-vrana, Dushta-vrana):
'Dushtavrana' specifically indicates chronic wounds that fail to heal properly. Understanding Dushtavrana necessitates targeted therapeutic interventions to resolve complex cases and promote timely tissue regeneration and recovery.

13) Surface:
In the context of wounds, 'Surface' refers to the external tissue layer that can be damaged. Understanding its condition helps in assessing the healing process. The integrity of the surface layer is crucial for proper wound closure and prevention of infections.

14) Ahara:
'Ahara' means food and is a pivotal concept in Ayurveda. It signifies not only dietary intake but also the quality of food which influences dosha balance and overall health. Proper Ahara aids in recovery from wounds by providing essential nutrients necessary for healing.

15) Lakshana (Laksana):
'Lakshanas' (plural of 'Lakshana') identifies specific characteristics or signs of a condition. They serve as indicators for diagnosing the severity and type of Vrana, guiding practical approaches to optimize treatment outcomes based on clinical presentations.

16) Ropana:
'Ropana' pertains to the healing process of wounds. It encompasses methods and formulations that promote tissue regeneration and repair. Ropana techniques are vital in resolving Vrana and restoring skin integrity following injury or surgical procedures.

17) Shopha (Sopha):
'Shopha' refers to inflammatory swelling occurring in response to tissue damage. In the framework of wound healing, understanding Shopha is essential for managing pain and inflammation, effectively guiding treatment protocols to ensure appropriate healing.

18) Kapha:
'Kapha' is one of the three doshas representing earth and water elements, governing structure and stability. An imbalance in Kapha can lead to excess moisture in wounds, potentially causing complications. Understanding Kapha helps to balance treatments and promote healing.

19) Asthi (Ashthi):
'Asthi' refers to bone tissue in Ayurvedic medicine. Understanding Asthi is crucial in wound management as damage to bones can complicate healing processes. Proper care for injuries involving Asthi is necessary to ensure comprehensive recovery and functionality.

20) Nija:
'Nija' signifies internal or endogenous factors contributing to disease. In wounds, Nija conditions reflect issues arising from within the body, such as metabolic disorders. Recognizing Nija is critical for effectively addressing root causes and promoting healing.

21) Ayurveda (Ayus-veda):
'Ayurveda' is the ancient system of medicine from India, focused on holistic health and well-being. It integrates lifestyle, diet, and herbal treatments, emphasizing the balance of doshas to prevent disease and maintain health, including wound care management.

22) Mamsa (Mamsha):
'Mamsa' refers to muscle or flesh tissue in Ayurvedic terminology. Understanding Mamsa is crucial for managing wounds that penetrate deeper than the epidermis. The healing of Mamsa is integral for restoring functionality and preventing complications in traumatic injuries.

23) Snayu:
'Snayu' denotes connective tissue or sinews in Ayurvedic contexts. Proper healing of Snayu is vital in wounds involving ligaments, tendons, and supportive structures. Understanding Snayu helps guide treatments to restore mobility and functionality in affected areas.

24) Dhatu:
'Dhatu' refers to the seven fundamental tissues in Ayurveda: Rasa (plasma), Rakta (blood), Mamsa (muscle), Meda (fat), Asthi (bone), Majja (marrow), and Sukra (reproductive tissues). The health of these tissues is crucial for overall health and healing processes.

25) Blood:
'Blood' signifies a vital fluid in the body, linked primarily with the Rakta dhatu. Its role encompasses nutrient transportation and immune response. In wound healing, proper blood circulation is essential for delivering healing components to the injured site.

26) Rasa (Rasha):
'Rasa' translates to plasma or the vital fluid that circulates in the body. It’ critical in transporting nutrients and supporting the body's hydration and vitality. Understanding Rasa is important in Ayurveda as it impacts all bodily functions, including healing mechanisms.

27) Sira (Shira):
'Sira' signifies veins or blood vessels in Ayurveda. Understanding the condition of Sira is essential for ensuring proper blood flow, which is crucial for healing injuries and wounds. The integrity of blood vessels directly impacts wound healing and recovery processes.

28) Swelling:
'Swelling' typically indicates inflammation or fluid accumulation at the injury site. Recognizing swelling is vital for assessing the condition of a wound and guiding treatment strategies in Ayurveda to mitigate inflammation and promote faster healing.

29) Vitiation (Vitiated):
'Vitiation' describes the disruption or impairment of dosha balance within the body, leading to diseases. In wound healing context, addressing vitiation is essential to ensure a conducive environment for recovery and prevent complications from arising.

30) Koshtha (Kostha):
'Koshtha' refers to the cavity or hollow structures within the body. Recognizing its significance is essential in Ayurveda, particularly when addressing conditions related to internal organs. In the context of Vrana, Koshtha can relate to complications from deep tissue wounds.

31) Burning (Burn, Burned, Burnt):
'Burning' describes a specific sensation often associated with inflammation or infection in wounds. In Ayurvedic terms, it usually indicates a Pitta dosha imbalance. Its recognition helps guide treatment approaches focused on cooling and soothing affected areas.

32) Sandhi (Shandhi, Samdhi):
'Sandhi' refers to joints in Ayurvedic contexts. Understanding the condition of Sandhi is critical when dealing with wounds in or around joints, as these injuries may require specific care to restore mobility and prevent long-term complications.

33) Sthana:
'Sthana' pertains to the location or site of injury within the body. Recognizing Sthana is crucial for effective treatment in Ayurveda, as the site of the wound influences its healing response and the choice of therapeutic measures.

34) Rakta:
'Rakta' signifies blood in Ayurvedic terminology. Its importance in wound healing is paramount as it carries nutrients and immune cells essential for recovery. The quality and flow of Rakta determine the healing process in any injury.

35) Burning sensation:
'Burning sensation' commonly associated with wound inflammation indicates Pitta imbalance in Ayurveda. Recognizing this symptom is crucial for selecting appropriate treatments aimed at cooling the affected area and mitigating discomfort during the recovery process.

36) Shuddha (Suddha):
'Shuddha' indicates purity or cleanliness in Ayurveda, especially in wound management. A Shuddha Vrana signifies a pure wound free from infection, essential for promoting optimal healing outcomes and guiding treatment plans.

37) Dushya (Dusya):
'Dushya' refers to the substances in the body that become vitiated and contribute to diseases like Vrana. In the context of wound healing, understanding the role of Dushya helps in addressing underlying issues complicating the healing process.

38) Lavana:
'Lavana' signifies salt in Ayurveda. It plays a dual role in promoting digestive health and for certain topical applications in wound management. Proper usage of Lavana can aid in healing but must be balanced to avoid excessive dryness.

39) New Delhi:
'New Delhi' is the capital city of India, representing a hub of Ayurvedic knowledge and education. Its mention may indicate conduction of research or practices related to wound management and Ayurveda within the context of modern healthcare.

40) Pittadosha (Pittadosa, Pitta-dosha):
'Pitta-dosha' corresponds to the heated, metabolic principles in the body related to digestion and transformation. Imbalances in Pitta can lead to inflammation and complications in wound healing, making its management crucial in Ayurveda.

41) Kriyakala:
'Kriyakala' refers to the phases of disease progression in Ayurveda. Understanding Kriyakala stages is important for effective diagnosis and treatment of conditions like Vrana, guiding practitioners to intervene appropriately based on the disease's current state.

42) Medicine:
'Medicines' in Ayurveda encompass a wide array of herbs, oils, and formulations used to treat various conditions including wounds. They are crafted based on dosha balancing principles, underpinning the holistic nature of Ayurvedic healing methods.

43) Lekhana:
'Lekhana' involves the principles and practices aimed at scraping or cleansing wounds. It's crucial in Ayurvedic wound management, assisting in the removal of dead tissue and impurities, promoting a favorable environment for healing.

44) Upanaha:
'Upanaha' refers to a specific treatment procedure in Ayurveda that involves applying a warm, medicated paste to a wound, aiding in healing and alleviating pain. It highlights the practical application of Ayurvedic theories in managing injuries.

45) Itching:
'Itching' is a common symptom associated with skin conditions and wounds. In Ayurveda, it can indicate Vata or Kapha imbalances, often requiring targeted treatments to relieve discomfort and promote quicker healing of affected areas.

46) Tantra (Tamtra, Tantrism):
'Tantra' refers to systems or methods applied in a specific discipline. In the context of Ayurveda, it pertains to the methodologies and principles applied in surgical practices, especially in managing wounds (Shalya Tantra).

47) Shalya (Salya):
'Shalya' denotes surgery in Ayurvedic medicine. It's vital in managing complex wounds and conditions, illustrating the combined use of surgical techniques with herbal treatments to facilitate healing and restore tissue integrity.

48) Vamana:
'Vamana' refers to a therapeutic emesis (vomiting) procedure in Ayurveda aimed at purging excess Kapha. This treatment is vital both for cleansing and managing conditions that may contribute to wound healing complications through body balance restoration.

49) Taila (Thaila):
'Taila' translates to oil in Ayurveda. Used widely in treatments, it serves to nourish tissues, promote healing, and improve skin flexibility. Taila is essential in managing wounds, as it creates a moist environment conducive to healing.

50) Delhi:
'Delhi' refers to the capital city of India, which is significant as a cultural and educational hub for Ayurveda, where traditional practices are merged with modern medicine, promoting holistic health initiatives in the community.

51) Varna:
'Varna' refers to color and is essential in assessing wounds in Ayurveda. The coloration of a wound provides insight into its type and severity, guiding treatment choices by indicating underlying conditions or healing progress.

52) India:
'India' is the birthplace of Ayurveda, encompassing rich traditions and integrated health principles. The practices and teachings originating from India offer foundational knowledge for holistic healing, focusing on balance as a path to health.

53) Katu:
'Katu' signifies a pungent taste in Ayurveda that can stimulate digestion and metabolism. Its role in wound care relates to its potential use in medicines to promote healing while managing associated symptoms like pain.

54) Amla:
'Amla' refers to sourness in Ayurvedic terminology, representing one of the six tastes. It plays a role in balancing doshas and enhancing digestion, vital for overall health and supporting recovery during the healing of wounds.

55) Mala:
'Mala' refers to bodily waste or excreta in Ayurveda. Maintaining proper waste elimination is crucial to overall health and affects wound healing processes. Accumulation of Mala indicates a need to address underlying imbalances to promote healing.

56) Kala:
'Kala' represents time or phases in Ayurveda, reflecting the dynamics of health and disease progression. Recognizing the relevance of Kala helps practitioners understand when to intervene in treating wounds effectively, aligning treatments with the natural healing timeline.

57) Hair:
'Hairs' have significance in Ayurveda, influencing the health of the skin and underlying tissues. Their condition can reflect overall health, and in the case of wounds, their presence or absence can impact the healing process.

58) Shalyatantra (Salyatantra, Shalya-tantra, Shalyatamtra):
'Shalya-tantra' is the Ayurvedic surgical science focused on managing injuries and wounds. It integrates surgical practices with herbal medicine to promote healing, emphasizing the importance of understanding both anatomy and pathophysiology in treatment.

59) Vagbhata:
'Vagbhata' refers to an ancient Ayurvedic scholar whose texts preserve knowledge of medicine and surgery. His work contributes to the understanding of wound management practices and the integration of surgical techniques with holistic healing traditions.

60) Upakrama:
'Upakrama' signifies therapeutic interventions in Ayurveda. In relation to wound management, it highlights the comprehensive strategies adopted to treat injuries, emphasizing the importance of individualized approaches for optimal healing outcomes.

61) Sandhana (Samdhana):
'Sandhana' means the surgical technique of suturing or closing a wound. Proper Sandhana techniques are crucial in wound management to restore tissue integrity, ensuring effective healing while minimizing complications or infections.

62) Krishna (Krsna):
'Krishna' refers to a color and can also indicate darker aspects in Ayurvedic contexts, particularly in symptoms or abnormalities. In wound management, color assessment influences understanding of the wound's nature and guides treatment options.

63) Kashaya (Kasaya):
'Kasaya' denotes astringent or medicinal properties that assist in cleansing wounds or balancing doshas. Its role in wound management emphasizes the need for appropriate applications to promote effective healing.

64) Pittaja (Pitta-ja):
'Pittaja' refers to conditions arising from Pitta dosha imbalance. Understanding Pittaja symptoms is vital in managing wounds as inflammation and infection can often stem from disturbances in Pitta, requiring targeted treatments to restore balance.

65) Dravya:
'Dravyas' refer to material substances used in Ayurvedic treatments, including herbs and compounds. Their proper selection and application are crucial for addressing conditions like wounds, ultimately supporting recovery based on individual patient needs.

66) Ruksha (Ruksa):
'Ruksha' translates to dryness in Ayurveda. In the context of wounds, Ruksha properties can be both beneficial and harmful, making it important to assess its effects on healing to apply appropriate treatments.

67) Vritta (Vrtta):
'Vritta' signifies circular or rounded shapes in wounds or lesions. Understanding Vritta can assist in identifying certain types of wounds and their characteristics, which ultimately influences the approach taken by practitioners in managing them.

68) Vihara:
'Vihara' encompasses lifestyle and activities in Ayurveda, influencing overall health. Its relevance in wound management pertains to maintaining healthy practices to support the healing process, including proper rest, movement, and avoiding harm to the wound site.

69) Akriti (Akrti):
'Akriti' refers to formation or shape in Ayurvedic diagnosis. Assessing the Akriti of wounds helps healthcare providers understand the underlying conditions and select appropriate treatments based on physical presentations.

70) Nidana:
'Nidana' denotes the cause or root of a disease. In the context of wounds, identifying Nidana is crucial for effective treatments, as it leads to a deeper understanding of underlying issues contributing to ulcerations or other injuries.

71) Shyava (Syava):
'Shyava' refers to a grayish color, often associated with certain types of lesions or wounds. Recognizing the Shyava coloration can provide insight into the nature of the wound, influencing diagnosis and management strategies.

72) Marma:
'Marma' designates vital points in Ayurveda that connect physical and energetic systems. Understanding Marma is essential during wound treatment to avoid damaging these sensitive areas, as injury to Marma can lead to significant consequences.

73) Vastu:
'Vastus' refers to the physical regions or sites within the body where health conditions manifest. Identifying Vastus helps practitioners focus interventions specifically on affected regions, enhancing the precision of treatments in managing health conditions.

74) Sarpis (Sarpi, Sarpish):
'Sarpi' denotes medicated ghee used in the Ayurvedic treatment of various conditions, including wounds. It is valued for its nourishing properties and ability to facilitate healing by promoting moisture retention and nutrient delivery to affected tissues.

75) Food:
'Food' encompasses dietary intake essential for maintaining health and promoting healing. In Ayurveda, what one consumes plays a significant role in balance among doshas and directly impacts recovery from wounds.

[Note: The above list is limited to 75. Total glossary definitions available: 279]

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Discover the significance of concepts within the article: ‘A systemic review on vrana and it’s management’. Further sources in the context of Science might help you critically compare this page with similair documents:

Dushtavrana, Prakopa, Prasara, Sanchaya, Vranavastu, Agantujavrana, Vata, Pitta, Kapha, Acharya Sushruta, Dosha, Dhatu, Mala, Chronic Wound, Intrinsic Factor, Nija Vrana, Pradhanakarma, Paschatkarma, Shuddha-Vrana, Systemic Review, Vrana Shopha, Shat-Kriyakala, Vrana management.

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