Comparative Clinical Evaluation of Karpura Ghrita Ointment and Jatyadi Ghrita Ointment in the Management of Post-Operative Wounds with Special Reference to Fissure-in-Ano

Abstract

Background: Post-operative wound management following anorectal surgeries, particularly Fissure-in-Ano repair, presents a significant clinical challenge due to the risk of pain, delayed healing, secondary infection, and poor patient compliance with dressing protocols. Classical Ayurvedic formulations have long been recognised for their wound-healing (Vrana Ropana) and cleansing (Vrana Shodhana) properties. Karpura Ghrita and Jatyadi Ghrita are two such preparations cited in Bhaishajya Ratnavali with established utility in post-operative wound care. Aim: To compare the clinical efficacy of Karpura Ghrita ointment versus Jatyadi Ghrita ointment in the management of post-operative wounds with special reference to Fissure-in-Ano. Methods: A prospective, randomised, parallel-group, open-label comparative clinical trial was conducted at the University Ayurved Hospital, Jodhpur (CTRI/2024/07/0710491). Forty patients aged 15-65 years with post-operative wounds following Fissure-in-Ano surgery were randomly allocated into two equal groups: Group A (n=20) received topical Karpura Ghrita ointment and Group B (n=20) received Jatyadi Ghrita ointment. Both interventions were applied locally for 7 days, followed by a 7-day follow-up. Outcome parameters included Pain (VAS), Burning Sensation, and Tenderness, each graded on a 0-3 ordinal scale. Statistical analysis was performed using the Mann-Whitney test (two-tailed) with GraphPad InStat 3.0. Results: Both formulations demonstrated statistically highly significant improvements in all outcome parameters (p=0.001). Group A (Karpura Ghrita) achieved 80.15%, 79.86%, and 79.85% relief in Pain, Burning Sensation, and Tenderness respectively. Group B (Jatyadi Ghrita) achieved 70.42%, 70.93%, and 70.89% relief in the corresponding parameters. Karpura Ghrita exhibited superior symptomatic relief compared to Jatyadi Ghrita across all assessed parameters. Conclusion: Both Karpura Ghrita and Jatyadi Ghrita are safe and effective topical Ayurvedic formulations for post-operative wound management following Fissure-in-Ano surgery. Karpura Ghrita demonstrated superior rapid symptomatic relief, while Jatyadi Ghrita offers broader wound-cleansing and tissue-regenerative benefits. Their integration into post-operative anorectal wound care protocols is recommended.

Introduction

The text discusses Fissure-in-Ano, a common and painful anorectal condition characterized by a tear in the anal canal, often associated with constipation and increased sphincter tension. Although surgical treatments like sphincterotomy are effective, proper post-operative wound care is essential for pain relief, infection prevention, and faster healing. Current modern treatments mainly focus on symptom relief rather than tissue regeneration.

In Ayurveda, this condition is referred to as Parikartika, and traditional treatments emphasize both cleansing and healing of wounds using medicated formulations. Two such formulations—Karpura Ghrita and Jatyadi Ghrita—are known for their analgesic, antimicrobial, and healing properties, but their comparative effectiveness has not been scientifically evaluated.

To address this gap, a randomized clinical trial was conducted with 40 patients divided into two groups, each receiving one of the formulations as a topical treatment after surgery. The study assessed outcomes like pain, burning sensation, and tenderness over a short treatment and follow-up period.

The aim of the study is to compare the safety and effectiveness of these Ayurvedic treatments in improving post-operative healing and to identify the more effective option for managing fissure-related wounds.

Conclusion

The present randomised comparative clinical trial demonstrates that both Karpura Ghrita ointment and Jatyadi Ghrita ointment are clinically efficacious, well-tolerated, and safe topical formulations for the management of post-operative wounds following Fissure-in-Ano surgery. Both interventions produced statistically highly significant improvement (p=0.001) in pain, burning sensation, and tenderness on day 7. Karpura Ghrita (Group A) demonstrated superior percentage relief in pain (80.15%), burning sensation (79.86%), and tenderness (79.85%) compared to Jatyadi Ghrita (Group B), which achieved 70.42%, 70.93%, and 70.89% respectively. Based on these findings, Karpura Ghrita is recommended for rapid symptomatic relief in the acute phase of post-operative fissure wound management, while Jatyadi Ghrita is appropriate for sustained wound healing, granulation tissue formation, and anti-infective coverage in the subacute and chronic phases. These classical Ayurvedic formulations offer a safe, cost-effective, and holistic alternative or adjunct to conventional post-operative topical wound care, addressing not only local wound pathology but also the systemic doshic imbalance underlying Parikartika. Their integration into contemporary anorectal surgical post-operative protocols merits serious consideration, particularly in resource-limited settings where access to conventional wound care products may be restricted.

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Copyright

Copyright © 2026 Dr. Arun Bhati, Dr. Vishnu Dutt Sharma, Dr. Grishma Rakholiya, Dr. Rahul Mehra. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.