A CLINICAL STUDY TO EVALUATE THE EFFICACY OF NIMBADI YOGA IN THE MANAGEMENT OF VRANA W.S.R. TO POST-OPERATIVE WOUND OF THE SENTINEL PILE

Abstract

Background: Sentinel pile is a common sequela of chronic fissure-in-ano and often requires surgical excision when conservative management fails. Although surgical excision effectively removes the lesion, the resulting post-operative wound remains vulnerable to pain, delayed healing, Repeated infection, if proper hygiene is not maintained after defecation. Ayurveda describes several Vrana Ropana (wound-healing) formulations, among which Nimbadi Yoga, mentioned in Yogaratnakara, possesses significant Vranashodhana (wound cleansing) and Vranaropana (wound healing) properties. However, clinical evidence regarding its efficacy in post-operative anorectal wounds is limited. Aim: To evaluate the efficacy of Nimbadi Yoga Ointment in the management of postoperative wounds following sentinel pile excision and compare its effectiveness with Jatyadi Taila. Materials and Methods: A non-randomised, prospective, open-label, double-arm interventional clinical study was conducted on 40 patients with postoperative wounds following sentinel pile excision. Patients were allocated into two groups comprising 20 patients each. Group A received topical application of Nimbadi Yoga Ointment, whereas Group B received Jatyadi Taila. Both groups were advised hot water sitz bath and Triphala Churna throughout the treatment period. Clinical assessment was performed on Days 0, 7, 14, 21, and 28 using pain (VAS), wound size, wound colour, Unit Healing Time (UHT), and Healing Index as outcome measures. Appropriate statistical tests were applied, and a p-value <0.05 was considered statistically significant. Results: Both groups demonstrated statistically significant improvement in pain, wound size, and wound colour from baseline (p<0.001). Group A showed numerically greater improvement in pain relief (96.61%) and wound size reduction (91.11%), whereas Group B demonstrated slightly higher improvement in wound colour (86.67%). However, intergroup comparisons for pain, wound size, wound colour, Unit Healing Time, and Healing Index revealed no statistically significant difference (p>0.05), indicating comparable therapeutic efficacy. Conclusion: Nimbadi Yoga Ointment was found to be safe, effective, and therapeutically comparable to Jatyadi Taila in the management of post-operative wounds following sentinel pile excision. Considering its wound-cleansing, antimicrobial, anti-inflammatory, and wound-healing properties, it may serve as a useful Ayurvedic alternative for post operative wound care.