A CLINICAL CASE STUDY ON THE EFFICACY OF COMBINED SYSTEMIC AND TOPICAL VEDNASTHAPAN REGIMEN IN ACHIEVING COMPLETE REMISSION OF SEVERE POST-FISSURECTOMY PAIN AND ACCELERATED WOUND HEALING

Abstract

Background: Post-operative Fissure-in-Ano pain is characterized by severe, prolonged discomfort often perpetuated by internal anal sphincter spasm, necessitating effective pain management and accelerated wound repair (Vrana Ropana). Conventional therapies often present limitations or side effects. This case report evaluates a comprehensive Ayurvedic approach utilizing the therapeutic principle of Vedanasthapan Karma (Pain relief) and Vrana Chikitsa (wound care) through a dual systemic and local regimen.

Case Presentation-A 32-year-old male, diagnosed with Post-operative Fissure in Ano, presented with severe, intermittent pain lasting 4-5 hours after defecation, a baseline Visual Analogue Scale (VAS) score of 6/10, hard stool consistency, and observable spasmodic sphincter tone. The surgical site was a fissurectomy wound measuring 1.7- 0.2 cm at the 6 O’clock position (Grade 2 wound).

Intervention-The patient was enrolled in an open-label therapeutic trial receiving a combined regimen for 28 days. The intervention consisted of Vednasthapan Vati (Oral, 1g twice daily) taken after meals with lukewarm water, and Vednasthapan Ointment (1–2g) applied locally upon the post-operative wound once daily during dressing. The formulation utilizes drugs from the classical Vednasthapan Mahakashay of Acharya Charaka, known for their potent anti-inflammatory and analgesic properties.

Results-The patient exhibited a rapid and sustained therapeutic response. The Pain VAS score dropped dramatically from 6 (Baseline) to 2 (8 hours post-dose), demonstrating immediate analgesic action. By the 14th day of follow-up, all symptoms had resolved: Pain VAS was 0, pain duration after defecation was 0 hours, and the wound size achieved Grade 0 (complete epithelialization).¹ The patient’s overall result was assessed as Complete Remission (100% improvement) with no reported Adverse Drug Reactions (ADR) throughout the trial period.

Conclusion-The integrated systemic and local Vednasthapan therapy demonstrated remarkable efficacy in the management of severe post-fissurectomy pain and significantly accelerated wound healing. The dual approach, addressing both systemic Vata vitiation and local tissue repair, offers a rapid, safe, and holistic management strategy highly suitable for post-surgical care in Shalya Tantra practice.