Diabetic foot ulcer with osteomyelitis, successfully treated with the holistic approach of multiple ayurvedic treatment modalities - A case report
Bopparathi S, K V NR (2023) · International Journal of Surgery Case Reports · n=1
Perfil del estudio
- Diseño
- single-patient Ayurveda case report of multimodal Ayurvedic treatment including medicinal leech therapy (MLT) for diabetic foot ulcer with osteomyelitis (National Institute of Ayurveda, Jaipur, Rajasthan, India)
- Tamaño de la muestra (n)
- 1
- Intervención
- Multimodal Ayurvedic regimen including surgical debridement, medicinal leech therapy (MLT), irrigation with Triphala decoction, jatyadi tail dressings, oral Ayurvedic antidiabetic medications, and herbo-mineral antimicrobial preparations in a 48-year-old female with uncontrolled type 2 diabetes presenting with gangrenous deep circular plantar ulcer (3×4 cm) with first-webspace involvement and X-ray-confirmed osteomyelitis after 3 months of failed conventional antibiotic and antidiabetic therapy
- Comparador
- Not applicable - single-patient case report; pre/post within-subject timeline with prior failed conventional therapy as historical control
- Punto final primario
- Wound healing, prevention of amputation, control of blood sugar, and resolution of osteomyelitis through holistic Ayurvedic management
- Resultado primario
- Holistic Ayurvedic approach including medicinal leech therapy successfully treated diabetic foot ulcer with osteomyelitis in a patient previously recommended for toe amputation; wound healing achieved without amputation; authors conclude that holistic Ayurvedic modalities are effective and safe in treating DFUs with osteomyelitis and in preventing amputation
- Duración del seguimiento
- post-multimodal-treatment wound-healing period
- PMID
- 37207585
Hallazgos clave
- Documents multimodal Ayurvedic limb-salvage approach including medicinal leech therapy in DFU with osteomyelitis
- Patient avoided recommended toe amputation - clinically meaningful patient-centered outcome
- Adds the National Institute of Ayurveda perspective to the global leech-therapy diabetic foot ulcer literature
- Documents that medicinal leech therapy can be integrated with conventional surgical debridement and herbal-mineral antimicrobial care
- Provides cross-cultural utilization signal for Ayurvedic CAM management of DFU complications
Limitaciones
- Single case (n=1) - cannot establish efficacy
- Highly multimodal intervention precludes attribution to leech therapy alone
- No randomized comparator versus standard amputation pathway
- Long-term durability of healing and recurrence rates not reported
- Selection bias - successful Ayurveda case reports tend to be over-represented in CAM literature
Implicaciones clínicas
Bopparathi 2023 documents that integrated Ayurvedic management including medicinal leech therapy may achieve limb salvage in DFU with osteomyelitis where conventional care had failed. For US clinicians, the case does not support routine adoption — the multimodal Ayurvedic intervention is not the standard US wound-care pathway and direct comparison to standard surgical care is not available. The trial is included in the registry to document the cross-cultural utilization of leech therapy as an adjunct in limb-salvage strategies for complex DFU. It complements the Nayak 2008 diabetic-foot RCT and the Zaidi 2014 Unani DFU case in framing the global Ayurveda/Unani CAM landscape for DFU management.