Comparative review of Vrana Shodhana and Vrana Ropana dravyas in Dushta Vrana management

Introduction

Chronic wounds remain a major healthcare challenge due to impaired healing, persistent infection, hypoxia, and systemic metabolic dysfunction such as diabetes mellitus and vascular insufficiency. In Ayurveda, these conditions are categorized under Dushta Vrana, resulting from vitiation of Rakta, Pitta, and Kapha Doshas along with local tissue contamination.

Classical surgical literature authored by Sushruta emphasizes a staged approach to wound management, beginning with purification (Shodhana) followed by regeneration (Ropana). This sequential strategy ensures removal of pathology before tissue repair begins.¹

Vrana shodhana dravyas (Cleansing and debridement agents)

Shodhana Dravyas are primarily indicated in infected, sloughy, and inflamed wounds. Their actions include antimicrobial activity, removal of necrotic tissue, reduction of exudate, and suppression of infection.

Key shodhana herbs

Nimba (Azadirachta indica):

• Strong antimicrobial and antiseptic activity
• Inhibits bacterial biofilms
• Reduces inflammation and purulent discharge

Haridra (Curcuma longa):

• Curcumin-mediated anti-inflammatory effect
• Promotes early wound cleansing
• Antioxidant protection against tissue damage

Daruharidra (Berberis aristata):

• Berberine exhibits broad-spectrum antimicrobial action
• Effective against wound pathogens
• Supports reduction of infection load

Karanja (Pongamia pinnata):

• Antibacterial and antifungal properties
• Helps in wound sterilization
• Promotes early debridement

Mechanism of action (Shodhana Phase):

• Inhibition of microbial growth
• Reduction of inflammatory mediators (TNF-α, IL-1β)
• Autolytic and chemical debridement support
• Clearance of necrotic tissue and slough

Vrana ropana dravyas (Healing and regenerative agents)

Ropana Dravyas are used after wound cleansing to promote tissue repair, angiogenesis, fibroblast proliferation, and epithelialization.

Key ropana herbs

Jati (Jasminum officinale):

• Enhances epithelial regeneration
• Anti-inflammatory and antimicrobial effects
• Promotes wound contraction

Yashtimadhu (Glycyrrhiza glabra):

• Glycyrrhizin inhibits inflammatory cytokines
• Promotes collagen synthesis and fibroblast activity
• Improves scar quality

Ghrita (Medicated Ghee):

• Lipid-based carrier for deep tissue penetration
• Enhances bioavailability of herbal actives
• Moisturizes wound bed and supports healing

Ghrita-based formulations (e.g., Jatyadi Ghrita/Taila):

• Synergistic wound-healing action
• Anti-inflammatory and antimicrobial effects
• Supports granulation tissue formation

Comparative analysis: Shodhana vs Ropana dravyas

Clinical applications

This dual-drug strategy is used in:

• Diabetic foot ulcers
• Venous leg ulcers
• Pressure sores
• Chronic infected wounds (Dushta Vrana)
• Post-surgical infected wounds
• Traumatic non-healing ulcers

Conclusion

The Ayurvedic wound management system is fundamentally stage-based, integrating Vrana Shodhana and Vrana Ropana Dravyas in a sequential therapeutic model. Shodhana herbs focus on infection control and debridement, while Ropana herbs promote tissue regeneration and restoration of normal skin architecture.² Modern pharmacological evidence strongly supports this complementary strategy, validating its relevance in chronic wound care and integrative surgical practice.

Reference:

1. Joshi, Foram & Dudhamal, Tukaram. (2025). Current Clinical Practice of Wound Management through Ayurveda : A Scoping Review. Journal of Natural Remedies. 1031-1036. 10.18311/jnr/2025/44613. https://www.researchgate.net/publication/392421673
2. Dudhamal TS. Review of grey literature on Ayurveda wound healing formulations and procedures - A systematic review. J Ayurveda Integr Med. 2023;14(4):100779. doi:10.1016/j.jaim.2023.100779 https://pmc.ncbi.nlm.nih.gov/articles/PMC10424143/