Swetha1, Vijayakrishna V2
Non-healing ulcer is a harmful result of delayed wound healing. It can arise due to various factors such as venous stasis, atherosclerotic changes in the arteries or other causes such as uncontrolled diabetes and trauma. The normal wound healing process is dynamic and complex having 3 phases, namely Inflammation, Tissue formation and Tissue remodeling. Arterial ulcer occurs because of inadequate perfusion of skin and subcutaneous tissue at rest resulting in tissue hypoxia and tissue damage. The main causes of arterial ulcers are a positive family history of premature atherosclerotic diseases or secondary causes such as smoking, with males predominantly being affected. According to a study conducted in USA, arterial ulcers are the second most common wound type (10%). They are commonly located at points such as toes, heels and bony prominences. Conventional therapy shows that limb salvage can be achieved in most patients with arterial insufficiency and uncomplicated chronic non healing limb ulcer using a program of wound management with revascularization. The other methods include topical use of collagen and topical zinc oxide and platelet rich plasma injections to promote wound healing. However, in severe arterial compromise, healing occurs in only about 50% of the cases, despite aggressive therapy.
Healing process slowly ABI <0.5
Angiography will reveal the disease symptoms and their severity determine whether intervention is needed.
The growth factors and growth factor receptors in non healing is charming ulceration Healing of purely ischaemic ulcers is characterised by vasculogenesis associated with increased presence of proangiogenic cytolines PDGF and TGF beta 3 promise for the use of growth factors manifestation to aid healing in ischaemic ulcer .
Biopsies showed prominent areas of angiogenesis with in the dermis of the ulcer base in all cases angiogenesis is commonly seen with in the granulation tissue at the edge of healing wounds
The formation of true new blood vessel or angiogenesis and the development of collateral vessels from pre existing blood vessels.
Influence factors such as bFGF and VEGF endothelial cells proliferate and form capillary buds growth factors are deficient VEGF, basic fibroblasts GF (bFGF).
- The 49 year old male patient presented with complaint of swelling of right foot with severe burning prominent over the wound site with coldness of the both limbs since 3months
- Ulcer wound was between the toes he has been on conventional treatment
- Characteristics symptoms which plays important role the patient describe the pain of both limbs and the burning of wound site region which is more after sleep better stretching
- Patient describe boils which was at anal region if it release discharge he is used to better the pain
- The same with presenting if the wound site if it has some discharge I feel better.
Based on totality of symptoms presented he was prescribed lachesis 30/BD/3days
5/01/2023 : lachesis 30/BD/3days was given
Within 8 hours of medication the swelling of foot slightly reduced
Burning in rectum with boils near rectum region which was his earlier symptom was reappearing.
6/01/2023_ Burning in anal region is better
DISCUSSION AND CONCLUSION– In this case Lachesis 30/bd/3days was prescribed as a Individualized Homeopathic medicine as per the totality of symptoms Each case is unique, in this case characteristic peculiarities are burning and pain better by pustular discharge and aggravation after sleep.
Arterial ulcers are one of the common debilitating condition of the current era whichaffects quality of life of affected individual thus impairing his day to day activities and also affecting his cosmetic appearance, Though it may not cause mortality, but increases the suffering of the patient from months to years. In further it may lead to gangrenous state,sepsis and finally leads to death.
This case gives evidence that how homoeopathic treatment can enhance the process of healing and helps in removing the underlying causes
- Grey JE, Harding KG, Enoch S. Venous and arterial leg ulcers. BMJ. 2006 Feb 11;332(7537):347-50. doi: 10.1136/bmj.332.7537.347. PMID: 16470058; PMCID: PMC1363917.
- Leung PC, Wong MW, Wong WC. Limb salvage in extensive diabetic foot ulceration: an extended study using a herbal supplement. Hong Kong Medical Journal. 2008 Feb 1;14(1):29.
- Chalimidi KR, Kumar Y, Kini UA. Efficacy of collagen particles in chronic non healing ulcers. Journal of Clinical and Diagnostic Research: JCDR. 2015 Jun;9(6):PC01.
- Akhundov K, Pietramaggiori G, Darwiche S, Guerid S, Scaletta C, Hirt-Burri N, Applegate LA, Raffoul WV. Development of a cost-effective method for platelet-rich plasma (PRP) preparation for topical wound healing. Annals of burns and fire disasters. 2012 Dec 12;25(4):207.
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Swetha1, Vijayakrishna V2
- Postgraduate scholar, Dept. of Homoeopathic materia medica, GHMC and H, Bengaluru 560079.
- BHMS, MD prof and PG guide, Department of Materia Medica. GHMC and H Bengaluru 560079