Abstract

Chronic wounds are difficult to heal because local tissue damage, impaired perfusion, systemic disease, inflammation, and microbial persistence reinforce one another. Biofilms are now recognized as an important part of this cycle. Their extracellular matrix and altered microbial behaviour reduce susceptibility to host defences and antimicrobial treatment, allowing inflammation to continue even when overt infection is not obvious. Classical Ayurvedic surgery describes Dushta Vrana as an unhealthy, non-healing wound marked by discharge, odour, discoloration, pain, swelling, devitalized tissue, and delayed repair. Management begins with Vrana Shodhana—repeated cleansing, irrigation, drainage, and removal of unhealthy tissue—before Vrana Ropana is undertaken. This review compares that staged approach with contemporary wound-bed preparation and biofilmbased wound care. The strongest parallel is practical: both approaches recognize that a persistent wound must be reassessed and its wound bed repeatedly optimized rather than treated with a single antimicrobial intervention. Dushta Vrana is not synonymous with biofilm, and traditional preparations cannot be assumed to disrupt clinical biofilms without direct evidence. Integrative care should therefore preserve standard vascular assessment, pressure relief, glycaemic management, debridement, infection treatment, and appropriate dressings while investigating standardized Ayurvedic measures as possible adjuncts. Priorities include product quality, biofilm-relevant laboratory methods, controlled clinical trials, safety monitoring, and objective healing outcomes