American Society of Hirudotherapy

Healing with integrative management of Diabetic foot ulcer - A case report

Case report published in J Ayurveda Integr Med (2025)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportClinical TrialsKatkar R, Aadithyaraj KT, Rana U · Journal of Ayurveda and integrative medicine, 2025

Abstract

Diabetic foot ulcers (DFUs) occur in 15-25 % of diabetic patients at some point in their lifetime. The wide surgical debridement of the septic area is the cornerstone of diabetic foot ulcer treatment. There is a need to explore alternate therapies for DFU to reduce the risk of severe amputation. A 50-year-old male visited the Ayurveda OPD with a chronic ulcer on the plantar aspect of his right forefoot, which had persisted for two months. Ayurveda has considered Dushta vrana (∼septic nonhealing ulcer) and mentioned the Vrana upkrama (∼wound care measures) for its management. Among these Vrana upkrama, Jalauka avcharana (∼bloodletting using leech), Vrana Shodhana (∼wound cleansing measures) by Parisheka (∼therapeutic streaming of medicated decoction), Vrana ropana (∼wound-healing measures) are the three main wound care approaches along with Shamana (∼palliative therapy) for three months adopted in the present case for managing diabetic foot ulcers. DMIST tool was used to assess wound care at baseline and during follow-up. After three months of treatment, the integrated approach effectively shortens the healing time of DFUs, reduces the amputation rate and improves the standard of living of patients with DFUs with multiple Ayurvedic treatments.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeCase ReportsJournal Article

Summary

50-year-old male with two-month chronic foot ulcer treated by integrative Ayurvedic protocol — jalauka avcharana (leech bloodletting), parisheka (medicated streaming decoction), and shamana palliative therapy — over three months, with significant improvement on DMIST scoring.

Why This Matters for Hirudotherapy

This case report describes a 50-year-old male with a chronic diabetic foot ulcer treated over three months using an integrated Ayurvedic approach that included Jalauka avcharana (bloodletting using leech), Vrana Shodhana (wound cleansing via therapeutic streaming of medicated decoction), Vrana ropana (wound-healing measures), and palliative therapy. The DMIST tool was used to assess wound care, and the integrated approach was reported to shorten healing time, reduce amputation risk, and improve quality of life. The article is relevant to hirudotherapy through the traditional practice of leech bloodletting for nonhealing ulcers. However, it is a single case involving multiple concurrent interventions, precluding attribution of outcomes specifically to leech therapy.

Citation

Healing with integrative management of Diabetic foot ulcer - A case report.

Katkar R, Aadithyaraj KT, Rana U · Journal of Ayurveda and integrative medicine, 2025

Added to ASH library: May 26, 2026 · Site last updated: June 18, 2026

This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.