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Case Study Quick Response Code:

Topical application of Katupila (Securinega leucopyrus) in

Dushta Vrana (chronic wound) showing excellent healing
effect: A case study
Ahamed Shahan Ajmeer, Tukaram S. Dudhamal1, Sanjay Kumar Gupta1, Vyasadeva Mahanta1
Maharshi Hospital, Mount Lavinia, Colombo, Sri Lanka, 1Department of Shalyatantra, Institute for Post Graduate
Teaching and Research in Ayurveda, Gujarat Ayurved University, Jamnagar, Gujarat, India

Abstract
Securinega leucopyrus (Willd.) Muell. is known as Humari in India, Katupila in Sri Lanka and
Spinous fluggea in English. It is a desert climatic plant used topically in paste form for healing
of chronic and non‑healing wounds. Application of Katupila Kalka (paste) is used commonly in
the management of acute as well as chronic wounds in Sri Lanka as a folklore medicine. The
aim of this study is to evaluate the role of herbal paste of Katupila in the treatment of Dushta
Vrana (chronic wound). It is a single observational innovative case study. A female aged 40 years
presented with a non‑healing infected wound on her right buttock with a history of 2 months.
On examination, there was a rounded wound having black color necrosed tissue and slough with
foul smelling, measuring about 3 inch × 3 inch × 1 inch in diameter caused by pyogenic local
infection. The routine laboratory investigations were within normal limit except hemoglobin and
the swab culture test of the wound bed was reported infection of Staphylococcus aureus. This
case study showed effective wound healing by topical application of Katupila paste and sesame oil.
Key words: Dushta Vrana, Humari, Katupila, Securinega leucopyrus, wounds

Introduction
Sushruta has described 60 measures for the comprehensive
management of Vrana (wound), which includes local as well as
the systematic use of different drugs and treatment modalities
under a dedicated chapter. In the treatment of Vrana, Sushruta
mentioned the Dushta Vrana (chronic wounds), which is
difficult to heal.[1] Dushta is one in which there is localization of
three Dosha. Vrana, which had a bad odor, has abnormal color,
with profuse discharge, intense pain and takes a long period to
heal. Dushta Vrana is a long standing ulcer where removing
debris enabling drug to reach healthy tissue is more important.
In Ayurveda Dushta Vrana are treated effectively by Ghrita and
Taila preparations. Among Ghrita ‑ Karpuradi, Manjisthadi and
Karanjadi; while in Taila ‑ Jatyadi, Pilu, Durvadi, Asthishrinkala
showed effective in wound healing.[2]
Securinega leucopyrus (Willd.) Muell is known as Humari
in India, Katupila in Sri Lanka and spinous fluggea in
English [Figure 1]. It is a desert climatic plant used topically in
Address for correspondence: Dr. Tukaram S. Dudhamal,
Assistant Professor, Department of Shalyatantra,
I.P.G.T. and R.A., Gujarat Ayurved University,
Jamnagar ‑ 361 008, Gujarat, India.
E‑mail: drtsdudhamal@gmail.com
paste form for healing of chronic and non‑healing wounds. The
healing process becomes diminished in chronic wounds due
to reduced tissue regeneration, angiogenesis and neurological
problem.[3] There are so many research works have been carried
out for the management of chronic and non‑healing wounds,
but still it is a big confront for the medical professionals to
deal this problem comprehensively.[4‑6] In search of an effective
herbal preparation Katupila paste tried in this case and showed
effective in healing of chronic wound. Pharmacognostical study
of Katupila powder shows the presence of calcium oxalate
crystals, large amount of tannin and oil helpful in the treatment
of cuts and wounds.[7]
Case Report
A female patient, aged about 40 years, presented with
non‑healing chronic wound on the right buttock since
2 months in the Outdoor Patient Department (OPD) of Shalya
Tantra. Patient was thoroughly examined locally as well as
systematically. The local findings revealed a foul smelling deep
wound, having fixed and black slough area, around, that is,
3 inch × 3 inch × 1 inch. The culture swab report of the wound
was done, and it reported the presence of Staphylococcus aureus
infection. All the other laboratory findings were found to be
within normal limits except hemoglobin level, which was 8 g %.
Patient gave a history that she had taken treatment for wound

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 Ajmeer, et al.: Wound healing effect of Katupila (Securinega leucopyrus) in chronic wound
since last 1 month with dressing by antiseptic solution, but
there was no improvement in the wound. No any major
systemic disease or surgery reported by the patient.
Diagnosis
This chronic wound was diagnosed as trophic ulcer because the
ulcer was located at buttock region having less blood supply and
pressure point during sitting posture. This type of ulcer can also
be correlated with pressure ulcer.
Intervention
Local dressing of wound by Katupila powder mixed with sesame
oil was carried out.
The wound was cleaned with decoction of Panchavalkala. The
dried leaf powder of Katupila mixed with sesame oil was applied
on wound once daily. The Katupila dressing was continued until
complete healing achieved and the result was assessed at regular
intervals. Along with local dressing; capsule of hematinic drug
composed of vitamin B‑12, Ferrous Fumarate, vitamin C and
Folic acid was administered orally once a day for 30 days.
Observations
The characteristics of Dushta Vrana like Ativivrita
(broad base), Bhairava (ugly look), Putipuyamansa (pus
Figure 1: Shrub Katupila / Humari (Securinega leucopyrus)
Figure 3: After application of Securinega leucopyrus paste
176
discharge), Durgandha (foul smell), Vedana (pain),
Dirghakalanubandhi (chronic) were noted in the wound
[Figure 2]. There was deep seated blackish slough at the base
of the wound and which was hard to remove initially. The
wound was cleaned daily with Panchawalkala Kwatha and
then the paste made up of dried leaves powder of Katupila
with sesame oil was applied in adequate quantity [Figure 3].
Wound was bandaged after covering with sterilized gauze and
cotton pads.
It was noted that the deep seated slough, which was hard
to remove, started to dissolve from the base and wound
became clean and healthy on 4th day [Figure 4]. The healing
was started with the formation of healthy granulation tissue.
The margin of wound became bluish showing growing
epithelium. The wound started to contract by filling of tissue
from the base of wound day by day. The Katupila dressing
was continued, and on 21st day, it was observed that wound
size was markedly reduced with normal skin coloration at the
healed area [Figure 5]. On the 35th day, the wound was healed
completely with minimum scar tissue formation [Figure 6].
After completion of a month, the hemoglobin was increased
and became 10 g %.
Figure 2: Dushta vrana (infected non-healing wound) at left
buttock on 1st day of treatment
Figure 4: Status of wound on the 4th day of treatment
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 Ajmeer, et al.: Wound healing effect of Katupila (Securinega leucopyrus) in chronic wound
Figure 5: Wound status on the 21st day after treatment
Discussion
According to Acharya Sushruta, among the 60 measures of
comprehensive wound management, Kalka (paste) is indicated
in cases of chronic wound, which is full of slough, deep seated
in muscle and reluctant to heal.[8] The paste performs both
the functions of Shodhana (cleansing) and Ropana (healing)
in cases of Dushta Vrana. Extracts of the Katupila leaves
exhibited a broad spectrum antimicrobial activity, which is an
important requirement of wound healing by controlling and
reducing the microbial load.[9,10] In this case, the black slough
removed on 4th day without surgical debridement because
Katupila has Kashaya Rasa (astringent taste), which exerted
Lekhana (scraping) action that helped in removing slough and
prepared the wound bed for healing.[11] Wound became clean
with healthy granulation on 21st day as Katupila is having the
ability to disinfect and destroy the micro‑organisms in cases of
sores acted as a disinfectant and promoted excellent healing.[12]
Signs and symptoms such as pain, discharge, discoloration,
bad odor, etc., are considered due to active involvement of
Tridosha. The Tikta Rasa (bitter taste) of the Katupila and
Snigdha Guna of sesame oil pacified the vitiated Doshas,
rendered relief in pain, discharge which were proven helpful
in the healing process of wound.[13] All those properties of
drug assisted in cleaning the wound and helped to inhibit the
growth of micro‑organisms. Another property of Katupila is
antioxidant activity due to the presence of some flavanoids and
tannins in abundant quantity. Tanin is supposed to be having
wound healing property, which helped in wound healing.[14] It
acted as scavenger and probably helped to remove free radicals
as well as inhibited further generation of free radicals.[15,16]
Patient was anemic at the first consultation; systemic use
of hemainic capsule had also played an important role to
increase hemoglobin level and general condition of the patient.
Anemia is one of cause for non‑healing of wound so improving
hemoglobin level by hematanic ultimately promoted wound
healing. The hemoglobin in the blood circulation nourishes the
newly generated cell.[17] It is supposed to be the systemic effect
of Hematinic drug and local effect of Katupila for wound
healing.
After application of the Katupila paste the wound became
clean and free from slough and foul smell within 3 days. There
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Figure 6: Complete healed wound with minimum scar on the 35th
day
was a significant increase in granulation tissue showing good
healing effect after 15 days. The wound became contacted
markedly by 21 days, and complete wound healing was observed
by 35 days (5 weeks). After wound healing, there was little
formation of scar tissue with noticeable pigmentation. There
were no any adverse events noted throughout the treatment
and healing occurred uneventfully. The dressing of Katupila in
chronic wound is found to be cost‑effective, safe, and easy to
implement.
Conclusion
This single case study highlighted the topical application of
Katupila (S. leucopyrus [Willd.]). Muell paste with sesame oil
was found very effective and shown excellent healing effect in a
case of chronic and nonhealing wounds.
Acknowledgments
The authors acknowledge Prof. M. S. Baghel ‑ Director, IPGT and RA,
GAU, Jamnagar for motivation and kind support.
References
1. Sushruta. Susrutha Samhitha, Sutra Sthana, Krutyakrutavidhi Adhyaya, 23/7,
edited by Shastri A, 12th ed. Chaukhambha Sanskrita Sansthan, Varanasi,
2001; 98.
2. Sathish HS, Baghel MS, Bhuyan C, Gupta SK, Dudhamal TS. Review of
clinical observational studies conducted on tissue healing at I.P.G.T.
and R.A., Jamnagar. International Journal of Research in Ayurveda and
Pharmacy 2011; 2 (1):13‑17. Available on http://www.ijrap.net/admin/php/
uploads/352_pdf.pdf [Last accessed on 2013 May 06].
3. P. Ronan O’Connell, Norman Williams, Christopher Bulstrode. Wound
tissue repair and scars. Bailey and Love’s Short Practice of Surgery.
25th ed. Landon: Adward Arnold Publishers Ltd.; 2008. pp. 24‑31.
4. Datta HS, Mitra SK, Patwardhan B. Wound healing activity of topical
application forms based on Ayurveda. Evid Based Complement Alternat
Med 2011;2011:134378.
5. Dudhamal TS, Gupta SK, Bhuyan C. Role of honey (Madhu) in
the management of wounds (Dushta Vrana). Int J Ayurveda Res
2010;1:271‑3.
6. Vijaya KK, Nishteswar K. Wound healing activity of honey: A pilot study.
Ayu 2012;33:374‑7.
177
 Ajmeer, et al.: Wound healing effect of Katupila (Securinega leucopyrus) in chronic wound
7. Ajmeer AS, Harisha CR, Dudhamal TS, Gupta SK. Micromorphological
and micrometric evaluation of Securinega leucopyrus (Willd.) Muell. Leaf
and stem‑unexplored drug. Int J Sci Invent Today 2013;2:140‑9.
8. Sushruta, Susrutha Samhitha, Chikitas Sthana, Dwivraniya Adhyaya, 1/55,
edited by Yadavji Trikamji Acharya, 12th ed. Chaukhambha Sanskrita
Sansthan, Varanasi, 2001; 8.
9. Bakshu LM, Jeevan Ram A, Venkata Raju R. Antimicrobial activity of
Securinega leucopyrus. Fitoterapia 2001;72:930‑3.
10. Santhapu H. Plants of Saurashtra A Preliminary List. Humari (Securinega
leucopyrus) Rajkot: S.J.F.N.I Saurashtra Research Society; 1953.
11. Bhavamishra, Bhavprakasha, Part‑1, Mishraprakaranam, 6/192, edited by
Pandit Mishra BS, Vaisya SR, 11th ed. Chaukhambha Sanskrit Bhawan,
Varanasi, 2007; 187.
12. Paanduraphali‑ Securinega leucopyrus. Available from: https://www.
groups.google.com/group/bodhi‑nighantu/browse_thread/thread/
ce052aa26c217fb6. [Last accessed on 2013 May 08]
13. Sushruta, Susrutha Samhitha, Sutra Sthana, DravadravyaVidhi Adhyaya
45/112, edited by Yadavji Trikamji Acharya, 12th ed. Chaukhambha
Sanskrita Sansthan, Varanasi, 2001; 178.
14. Li K, Diao Y, Zhang H, Wang S, Zhang Z, Yu B, et al. Tannin extracts from
immature fruits of Terminalia chebula Fructus Retz. promote cutaneous
wound healing in rats. BMC Complement Altern Med 2011;11:86.
15. Vidyadhar S, Sheela T, Reddy LS, Gopal TK, Chamundeeswari D, Saidulu A,
Reddy CU. In vitro antioxidant activity of chloroform extract of aerial
parts of Securinega leucopyrus (Willd.) Muell. Der Pharmacia Lettre
2010;2(6):252‑56. Available from: http://www.scholarsresearchlibrary.
com. [Last accessed on 2013 May 08]
16. Megha G. In‑vitro anti‑arthritic activity of aerial parts of Securinega
leucopyrus (Willd) Muell, Euphorbiaceae SRMC and RI, Porur
PT‑066. Available from: http://www.jsscpooty.org/assets/pdf/
Selected‑List‑Category‑C.pdf. [Last accessed on 2013 Mar 30].
17. Plock JA, Rafatmehr N, Sinovcic D, Schnider J, Sakai H, Tsuchida E,
et al. Hemoglobin vesicles improve wound healing and tissue survival
in critically ischemic skin in mice. Am J Physiol Heart Circ Physiol
2009;297:H905‑10.
How to cite this article: Ajmeer AS, Dudhamal TS, Gupta SK, Mahanta V.
Topical application of Katupila (Securinega leucopyrus) in Dushta Vrana
(chronic wound) showing excellent healing effect: A case study. Ayu
2014;35:175-8.
Source of Support: Nil, Conflict of Interest: None declared.

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