Background: Necrotising fascitis is an invasive infection of skin and soft tissue, including deep fascia, with relative sparing of the muscle, resulting in gangrene. The treatment involves excision of the affected tissue, may be even amputation of the affected part. Aim: To evaluate the role of Ksharakarma (caustic cautery) and Jalukavacharana (hirudotherapy) as an alternate to surgery in the management of necrotising fascitis. Materials & Methods: A case of infected wound at the tip of the right index finger whose distal portions were gangrenous was applied with Kshara until there was adequate debridement of slough and later Jalukavacharana for acceleration of tissue perfusion to the wound site for early healing. Results: The necrotized area was completely debrided (by two sittings of Ksharakarma) and
healed (three sittings of Jalukavacharana) by 15 days, thus avoiding surgical amputation of the terminal phalanx. Conclusion: Ksharakarma and Jalukavacharana were found to be effective in managing the necrotising fascitis wound, thus avoiding amputation.
Key words: Caustic cautery, Gangrene, Hirudotherapy, Jalukavacharana, Ksharakarma, Necrotising fascitis
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