Healing with integrative management of Diabetic foot ulcer — A case report
Katkar R, Aadithyaraj KT, Rana U (2025) · Journal of Ayurveda and Integrative Medicine · n=1
RCT evidence detailTrial reference
GRADE Very LowInsufficient evidence
Study Profile
- Design
- single-patient Ayurveda integrative-management case report of a 50-year-old male with a 2-month plantar diabetic foot ulcer; multi-modal Vrana upkrama protocol including Jalaukavacharana (leech application), Parisheka (medicated streaming), and Vrana ropana (wound-healing measures); AIIMS Rishikesh + All India Institute of Ayurveda (New Delhi) + Banaras Hindu University
- Sample size (n)
- 1
- Intervention
- Jalaukavacharana (medicinal-leech bloodletting) combined with Vrana shodhana (medicated decoction streaming), Vrana ropana (wound-healing), and Shamana (palliative Ayurvedic therapy) over 3 months for plantar DFU
- Comparator
- Not applicable — single case; historical conventional wound care had failed prior
- Primary endpoint
- DMIST tool assessment of wound healing at baseline and through 3-month follow-up
- Primary result
- Integrated Ayurveda DFU protocol with jalauka (leech) bloodletting reduced healing time and improved DMIST wound-quality scores compared to baseline; authors report reduced amputation risk and improved patient quality of life; integrative protocol presented as a complementary approach when conventional management is insufficient
- Follow-up duration
- 3 months
- PMID
- 40896900
Key Findings
- AIIMS Rishikesh case report of integrative Ayurveda DFU management including leech bloodletting
- 3-month outcomes show reduced healing time and improved DMIST wound quality scores
- Multi-modal protocol (jalauka + parisheka + vrana ropana + shamana) — leech component not isolated
- Adds to Indian leech-DFU literature alongside Nayak 2008 RCT and Bopparathi 2023
- Documents tertiary-center Indian academic Ayurveda DFU practice
Limitations
- Single patient (n=1) — cannot establish generalizable efficacy
- Multi-modal protocol cannot isolate leech-therapy contribution
- No blinded outcome adjudication
- DMIST tool reported without baseline-blinded comparator
- 3-month follow-up insufficient for ulcer-recurrence assessment
Clinical Implications
Katkar 2025 adds an AIIMS-level Indian academic-medicine case report to the existing leech-DFU literature. For ASH, the case does not support extending US K040187 clinical practice to DFU but illustrates how integrative-medicine programs in India (AIIMS, BHU) document leech-therapy use in chronic-wound contexts. The case supports the broader need for properly powered DFU leech RCTs and integrative-medicine outcome standardization.