Importance and relevance of bandage techniques described in Sushruta Samhita: A review study

Alok Kumar

doi:10.4103/AYUHOM.AYUHOM_40_21

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REVIEW ARTICLE

Year : 2021 | Volume : 8 | Issue : 1 | Page : 13-15

Importance and relevance of bandage techniques described in Sushruta Samhita: A review study

Alok Kumar
Department of Shalya Tantra, North Eastern Institute of Ayurveda and Homoeopathy, Shillong, Meghalaya, India

Date of Submission	30-Jul-2021
Date of Decision	17-Sep-2021
Date of Acceptance	18-Sep-2021
Date of Web Publication	26-Nov-2021

Correspondence Address:
Dr. Alok Kumar
Department of Shalya Tantra, North Eastern Institute of Ayurveda and Homoeopathy, Mawdiangdiang, Shillong, Meghalaya
India

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/AYUHOM.AYUHOM_40_21

Abstract

Shalya Tantra is one of the eight branches of Ayurveda. The main literature of Shalya Tantra (Surgery) is Sushruta Samhita. Bandaging is an important part of trauma management; poor bandaging can compromise the whole process of management that can lead to serious consequences. Correct knowledge of the bandaging principle is very much essential for every member of the surgical team. In Ayurveda fifteen types of Bandhana Karma are mentioned out of them Acharya Sushruta has mentioned fourteen Bandhana Karma (bandaging techniques) along with the indication and contraindication of the bandaging and one Utsangi Bandhana Karma mentioned by Acharya Vagbhatta. In the present study, all the techniques are discussed with their importance and relevance in the modern-day surgical environment. In this review study, all the techniques seem still relatable and every surgical team must follow the principle of bandaging laid by Sushruta.

Keywords: Ayurveda, bandaging, Bandhana Karma, trauma

How to cite this article:
Kumar A. Importance and relevance of bandage techniques described in Sushruta Samhita: A review study. AYUHOM 2021;8:13-5

How to cite this URL:
Kumar A. Importance and relevance of bandage techniques described in Sushruta Samhita: A review study. AYUHOM [serial online] 2021 [cited 2023 Mar 31];8:13-5. Available from: http://www.ayuhom.com/text.asp?2021/8/1/13/331321

Introduction

Ayurveda is the most ancient science of life; it possesses eight branches;^[1] out of which Shalya Tantra (Surgery) is one of the imperative branches of Ayurveda. Sushruta Samhita is the oldest and most authentic literature of Shalya Tantra found to date. Acharya Sushruta gives a detailed description of wound management. He has mentioned Shastiupakram;^[2] (60 procedures) for the management of various conditions of wounds. Shastiupakram is key to success in wound management. Acharya Sushruta is considered the father of plastic surgery. As a wound is an integral part of the surgery, either surgeon heals the already present wound or the surgeon creates some wound during surgery and then heal that wound for the cure of that particular disease. There are so many factors that felicitate wound healing, bandaging is one of them. Improper bandaging may create more harm and delayed the healing process. For the successful management of any wound proper closing of an open wound and correct dressing is of prime importance. Sushruta has mentioned the wound closer techniques;^[3] in detail. For bandaging Sushruta has mentioned fourteen Bandhana karma;^[4] (Bandaging procedure) along with various types of bandaging material;^[5] like cloths made up of Karpas (cotton), wool of Aavika (Sheep), plants bark, leather, silk, Alabu (Luffa cylindrical) fiber, Lata/Bela (Vine) of creeps, Bamboo stick, Rope and various metals (like gold, silver, or steel). Acharya Sushruta has included all kinds of dressing material which have a function like cotton gauze, bandage, pad, elastic bandage, splints and metallic braces, etc., In the recent studies of European Tissue Repair Society has classified the bandaging materials into four types.^[6] These include extensile bandages, elastic bandages, compression bandages, and support bandages but Sushruta was many steps ahead and included splints and functional braces in the bandaging material as all are to improve the healing process. Correct bandaging has a crucial role in the healing process of all wounds, especially in venous ulcers. Sushruta;^[7] was very much precise than how tight the bandage should be applied, where to put knot and where bandage should be avoided depends on the site and that particular condition of the wound. Acharya Sushruta has mentioned the benefit of bandaging;^[8] as after applying optimal bandage any fracture or dislocation of a bone or joint patient can walk comfortably, the patient can sit comfortably, the patient can sleep comfortably because healing is always better when patient sleep well and feel comfortable. In the present study, the various aspects of bandaging have been discussed from an Ayurveda perspective especially the Sushruta's point of view. All fourteen methods of bandaging described by Sushruta and one Utsangi Bandhana karma by Acharya Vagbhatta are discussed with their relevance and importance in the current scenario. The modern correlation of the particular bandaging techniques is also discussed. Bandaging is an important part of surgical practice, and hence, it is very essential for the medical students as well as nursing staff to know the basic principle of bandaging. The present study revealed some important aspects of bandaging described in Sushruta Samhita.

Aim of the study:

To appraise, elaborate, and discuss the various aspects of bandaging described in Sushruta Samhita
To describe the various methods of bandaging in Sushruta Samhita and correlate them with the modern-day surgical techniques.

Material and Methods

All references of Bandhana Karma are collected and compiled from Sushruta Samhita, Astanga hridya and various modern textbooks of surgery. The various methods are discussed with their importance of there in enhancing wound healing.

Observations

Acharya Sushruta has described the bandaging materials that include different herbal, nonherbal and metallic objects. Acharya Sushruta;^[9] had advocated avoiding place knot over the wound site, the dressing material over must not be very rough or smooth. Sushruta advocated the tight bandaging in the gluteal, abdomen, axilla, inguinal, thigh and on the head, the optimal bandage should be applied over the ears, neck, penis, scrotum, back and lateral side of the trunk while loose bandaging should be applied over eyes, and joint. Optimal means that the bandage is not so loose not so tight.

Bandagings (Bandha) described in Ayurveda are

Kosha Bandha is the first bandage type described by Sushruta, it is indicated in the thumb and the joints of fingers. It can be correlated with the splints of fingers and thumb
Daam Bandha, as per Sushruta it is indicated in the narrow portion of the body as the genitalia of a female. It can be correlated with the spica or loop bandage^[10]
Swashtika Bandha, as per Sushruta it is indicated in joints, mediastinum region, palm, sole, and over the ear. It can be correlated with the figure of eight bandages
Anuvellita Bandha, as per Sushruta it is indicated in the limbs. This can be correlated with the spiral bandage
Pratoli Bandha, as per Sushruta it is indicated in the neck and penis. This can be correlated with the circular bandage, which is applied without pressure. It must be a little loose
Mandal Bandha, as per Sushruta it is indicated in the cylindrical body areas such as arms, trunk, and thigh it can be correlated with the spiral and reverse spiral bandage
Sthagika Bandha, as per Sushruta this technique is indicated in the distal end of the thumb, fingers, and penis. This bandaging technique can be correlated with the recurrent stump bandage
Yamaka Bandha, as per Sushruta it is indicated in the two close injuries present side by side or to immobilize the injured part with healthy part. This can be correlated with finger strapping. Here, the injured finger is fixed with the healthy finger to immobilize the injured finger far healing
Khatwa Bandha, as per Sushruta this bandage is advised in hanu (lower jaw), Shaknha (temporal), and Ganda (Cheeks) areas. This can be correlated with the four tailed bandages, barrel bandages, and mastoid bandages
China Bandha, as per Sushruta, this bandage is advocated in the Apanga (outer canthus of eyes) area. This can be correlated with the eye patch
Bibandha Karma, as per Sushruta this bandage is indicated in the Pristha (Back) and Udara (Abdominal) region. This can be correlated with the various modern abdominal dressing
Vitana Bandha, as per Sushruta this Bandha is indicated on sira (head). This can be correlated with the various head bandages like twisted bandages and capeline bandages
Gophana Bandha, as per Sushruta this bandage is advised on chibuka (Chin), Nasa (nose), Ostha (Lips), Ansa (shoulder), Basti (suprapubic/scrotum) region. This bandage can be correlated with the three-tailed, four tailed, or barrel bandages
Panchangi Bandha, as per Sushruta this type of bandage is advised in the injury of the supraclavicular region
One more Bandhana karma described by another Acharya Vagbhatta known as Utsangi Bandha;^[11] is used for the management of upper limb injury. This Bandhana karma can be correlated with the various slings applied in the injury like fracture and dislocation of the upper limb. These slings stabilize the injured part, provide support and reduce venous edema in the affected part so which enhances the healing process.

Discussion

Bandaging is a very important part of surgical management, despite good surgery poor bandaging may cause some serious postsurgical complications even may cost the life of the patient. Bandaging is used in many surgical conditions. The objective of bandaging is different in different conditions. Bandaging helps in bleeding control by pressure, provides rest and support to the affected part, retains the dressings and splints in position, prevents edema and swelling and is used to correct deformity.^[12] Sushruta was very much aware of the importance of bandaging. It is equally important for the surgeon to know that, what to do and what not to do. Sushruta has mentioned the condition where bandaging is indicated and the conditions where bandaging is prohibited. A few conditions such as traumatic inflammation, acute cellulitis, burn injury by heat or chemical, and gangrenous wound;^[13] bandaging must be avoided. The conditions such as wounds of leprosy, diabetic abscess, the wound developed by different poisonous material Sushruta give freedom to the surgeon to decide the bandaging.^[14] The principle laid by Sushruta for bandaging is still relevant and in modern-day surgery, we all are following the same. As Sushruta told if tight bandaging is applied over the joint, eyes then it may cause severe pain swelling and discomfort. If the loose bandage is applied over the gluteal regain, head, axilla, and thigh then it will not hold, the wound will expose and bandaging became ineffective.^[15] Although the principle of bandaging is still the same the material used for bandaging is changed due to continuous inventions in medical science. Nowadays the dressing materials are more skin-friendly, easy to apply, and sterilized that reduces the chance of postoperative infection up to a great extent.

Conclusion

This study concludes that the correct acquaintance of the principle of bandaging is most imperative for the better management of surgical conditions. The bandaging technique recommended by Acharya Sushruta and Vagbhatta is pertinent in now day too. With due course of time, the bandaging materials are changed but the principle of applications indication and contra-indications are still the same as mentioned in Sushruta Samhita approximately 5000 years ago. So as the contribution of Sushruta in plastic surgery is incomparable, similarly, the credit for the wound bandaging technique must be given to Sushruta too.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

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