Wound-healing potential of Nimbadi Kalka in diabetic foot ulcer: a clinical study

Abstract

Background: One of the most dangerous complications of diabetes mellitus is the loss of lower limb by amputation as a consequence to diabetic foot ulcer (DFU). The estimated global prevalence of DFU is around 6.3%. The DFU is a type of nonhealing ulcer. Ayurveda explains it as Dusta Vrana (chronic nonhealing ulcer). Depending on its etiological factor, it can also be termed as Pramehajanya Dusta Vrana (nonhealing ulcer due to diabetes). The general line of management of Pramehajanya Vrana (diabetic wound/ulcer) mentioned by Acharya Sushuta says that one should adopt the principle and protocol of Dusta Vrana management. While describing the Sasti Upakrama (60 modalities of ulcer management), Nimbadi Kalka (a paste where neem leaves are the main ingredient) is mentioned, having both Vrana Sodhana (cleansing) and Vrana Ropana (healing) properties and beneficial for nonhealing ulcer. Keeping in view the above factor, 15 patients of DFUs were taken with a baseline HbA1c (6–7). Aims: The aim of this study was to evaluate the wound-healing property of Nimbadi Kalka in DFU. Settings and Design: The study was an open-label single-arm prospective design to find the pre- and post-effect of Nimbadi Kalka application on DFU. Materials and Methods: The study was conducted on 15 patients of DFU excluding dropouts. Nimbadi Kalka was applied on daily basis over the wound site for 45 days. Assessment was done on parameters such as wound surface area, granulation tissue, and exudates. Results and Conclusion: Nimbadi Kalka shows a marked reduction in wound size and exudates. In the case of granulation tissue, on the 15th day of treatment there was a peak increase indicating the formation of granulation tissue. Hence, Nimbadi Kalka promotes wound healing by reducing the size of ulcer in DFU.