Changes

=== Indications and process of six fold surgical procedures ===

=== Indications and process of six fold surgical procedures ===

Six types of surgical procedures are described for treatment of ulcer such as ''patana'' (incision), ''vyadhana'' (puncturing), ''chhedana'' (excision), ''lekhana'' (scrapping), ''pracchana'' (scarification) and ''seevana'' (suturing). ''Patana'' procedure described by Charak is same as for ''bhedana'' by Sushruta. Any similar or new procedure can be applied in wound management as per the surgeon’s freedom. <ref>K. H. Krishnamurthy, editor Prof. P.V. Sharma, Bhela Samhita, Chikitsa sthana, Chap.27, Shloka 14-15, pp 468, Reprint 2008, Chaukhambha Visvabharati, Varanasi.</ref>

Six types of surgical procedures are described for treatment of ulcer such as ''patana'' (incision), ''vyadhana'' (puncturing), ''chhedana'' (excision), ''lekhana'' (scrapping), ''pracchana'' (scarification) and ''seevana'' (suturing). ''Patana'' procedure described by Charak is same as for ''bhedana'' by Sushruta. Any similar or new procedure can be applied in wound management as per the surgeon’s freedom. <ref>Bhela, Chikitsa sthana, Chap.27, Verse 14-15 . In:K. H. Krishnamurthy,Prof. P.V. Sharma Editors, reprint edition, Varanasi; Chaukhambha Visvabharati, 2008, pp 468. </ref>

==== ''Pidana'' (Compression) ====

==== ''Pidana'' (Compression) ====

==== Management of fracture and dislocation ====

==== Management of fracture and dislocation ====

The basic guidelines for management of fracture and dislocation are to stabilize the fractured bone or dislocated joint by application of splints. Proper alignment of bone is mandatory for healing of fractured bones.<ref>Kaviraja Ambikadutta Shastri, Sushruta Samhita, Ist part, chikitsa sthana Chap 3, shlok no.18-19, Reprint 2013, Chaukhambha Sanskrit Sansthan, Varanasi, pp 28</ref> Suitable dietary regimen should be followed with avoidance of ''vidahi'' (food which causes burning sensation) food.<ref>Kaviraja Ambikadutta Shastri, Sushruta Samhita, Ist part, chikitsa sthana Chap 3, shlok no.4-5 , Reprint 2013, Chaukhambha Sanskrit Sansthan, Varanasi, pp 27</ref> Strenuous exercise is not allowed during healing period due to risk of re-fracture and dislocation. Complications due to fracture of bone or dislocation of joint are managed as per condition. For e.g. If ulcer is due to fracture of bone then treatment of ulcer along with fracture management should be adopted.

The basic guidelines for management of fracture and dislocation are to stabilize the fractured bone or dislocated joint by application of splints. Proper alignment of bone is mandatory for healing of fractured bones.<ref>Sushruta. Chikitsa Sthana, Cha.3 Bhagnachikisitam Adhyaya verse 18-19. In: Kaviraja Ambikadutta Shastri Aacharya, Editors. Sushruta Samhita. Reprint ed. Varanasi: Chaukhambha Sanskrit Sansthan;2013. pp 28.</ref> Suitable dietary regimen should be followed with avoidance of ''vidahi'' (food which causes burning sensation) food.<ref>Sushruta. Chikitsa Sthana, Cha.3 Bhagnachikisitam Adhyaya verse 4-5. In: Kaviraja Ambikadutta Shastri Aacharya, Editors. Sushruta Samhita. Reprint ed. Varanasi: Chaukhambha Sanskrit Sansthan;2013. pp 28.</ref> Strenuous exercise is not allowed during healing period due to risk of re-fracture and dislocation. Complications due to fracture of bone or dislocation of joint are managed as per condition. For e.g. If ulcer is due to fracture of bone then treatment of ulcer along with fracture management should be adopted.

==== ''Eshanakarma'' (probing) ====

==== ''Eshanakarma'' (probing) ====

It is used in ulcer of narrow opening with expanded base (eg.undermined ulcers). Various types of probes are used in ulcer to know the direction of tract or cavity, depth and discharge from ulcer or sinuses. Generally probing is not done if ulcer is located at vital organs (''marma sthana'') but in specific conditions as in fistula in ano it can be performed. As per site of ulcer various probes either hard or soft can be used. If deep seated and located at fleshy area hard probe (metallic) is used, in superficially seated ulcers soft probe is used. Probing is essential to know the depth of wound particularly in ''nadivrana'' (sinus at any part of the body) or fistula (fistula-in ano is one kind). (Su. Su.25/10).

It is used in ulcer of narrow opening with expanded base (eg.undermined ulcers). Various types of probes are used in ulcer to know the direction of tract or cavity, depth and discharge from ulcer or sinuses. Generally probing is not done if ulcer is located at vital organs (''marma sthana'') but in specific conditions as in fistula in ano it can be performed. As per site of ulcer various probes either hard or soft can be used. If deep seated and located at fleshy area hard probe (metallic) is used, in superficially seated ulcers soft probe is used. Probing is essential to know the depth of wound particularly in ''nadivrana'' (sinus at any part of the body) or fistula (fistula-in ano is one kind).Sushruta. Sutra Sthana, Cha.25 Ashtavidashastrakarmeeya Adhyaya verse 10. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.</ref>

==== ''Vrana shodhana'' (cleaning of ulcer) ====

==== ''Vrana shodhana'' (cleaning of ulcer) ====