Wound healing potential of Pañcavalkala formulations in a postfistulectomy wound

Sushruta mentioned sixty measures for management of wounds. Panchavalkal is the combination of five herbs having properties like Shodhana (cleaning) and Ropana (healing) of wounds. Individual drugs and in combination have Kashaya rasa (astringent) dominant and useful in the management of Vrana (wounds) as well as Shotha (inflammations). A 35 years old male patient consulted in Shalya OPD with complaints like discharge per anum, induration and intermittent pain at perianal region since last five years. On inspection external opening was observed at anterior portion 1 O’ clock position which was four centimeter away from anal verge. That case was diagnosed as Bhagandara (fistula-in-ano) and was treated with partial fistulectomy and application of Guggulu based Ksharasutra in the remaining tract. The big fistulectomy wound was treated with local application of Panchavalkal ointment daily and simultaneous change of Ksharasutra. The wound was assessed daily for pain, swelling, discharge, size, and shape. The wound healed completely within two and half month with normal scar having good tissue strength. This case demonstrated that post fistulectomy wound can be treated with Panchavalkal ointment.