Shasti Upakrama of Sushruta Samhita – Ancient Science of Wound Care for the Modern World

More than 2,000 years ago, the great Indian surgeon Acharya Sushruta described a complete system of wound care called “Shasti Upakrama”, which means sixty different methods of treating wounds.

Modern medicine calls this “wound management.” Sushruta had already explained all stages of wound care – from prevention, cleaning, surgery, healing, and after-care.

Even today, doctors follow the same principles, though using modern tools.

Below is a simple explanation of all 60 treatments in easy language.

Group 1: Prophylactic Care (Before and Early Protection of Wounds)

These methods prevent infection and protect the wound.

1. Raksha Karma – Protecting the wound from dust and insects
2. Modern example: Using sterile covering
3. Bandhana – Proper bandaging
4. Example: Surgical dressing
5. Acchadana – Covering the wound
6. Example: Sterile gauze
7. Dhupana – Herbal smoke for killing germs
8. Example: Antiseptic fumigation
9. Vranadhupana – Special wound fumigation
10. Example: Disinfecting wound room
11. Pathya Vyavastha – Healthy diet advice
12. Example: High-protein diet
13. Apathya Varjana – Avoiding harmful food
14. Example: Avoid junk and spicy foods
15. Vihara Niyamana – Lifestyle control
16. Example: Bed rest and limited movement

Group 2: Immediate Care After Injury (Acute Phase)

These methods stop bleeding and prevent complications.

1. Stambhana – Stopping bleeding
2. Example: Applying pressure
3. Agnikarma – Heat cauterization
4. Example: Electric cautery
5. Kshara Karma – Chemical cauterization
6. Example: Chemical hemostatic agents
7. Sthirikarana – Stabilizing the wound
8. Example: Immobilizing the body part
9. Vedanasthapana – Pain relief
10. Example: Painkillers
11. Daha Prashamana – Burning sensation relief
12. Example: Cooling gels
13. Samsamana – Reducing inflammation
14. Example: Anti-inflammatory medicines

Group 3: Cleaning and Removing Dead Tissue (Cleansing Phase)

These remove pus and unhealthy tissue.

1. Prakshalana – Washing the wound
2. Example: Saline wash
3. Pariseka – Pouring medicated liquid
4. Example: Antiseptic irrigation
5. Shodhana – Detoxifying the wound
6. Example: Antibacterial dressing
7. Chedana – Cutting dead tissue
8. Example: Surgical debridement
9. Bhedana – Opening pus-filled areas
10. Example: Incision and drainage
11. Lekhana – Scraping unhealthy tissue
12. Example: Curettage
13. Visravana – Letting out pus
14. Example: Draining abscess
15. Pacana – Helping pus to mature
16. Example: Warm compress
17. Raktamokshana – Removing bad blood
18. Example: Controlled bloodletting

Group 4: Healing and Tissue Building Stage

1. Ropana – Promoting healing
2. Example: Healing ointments
3. Utsadana – Raising depressed tissue
4. Example: Collagen dressings
5. Brimhana – Nourishing the body
6. Example: Protein supplements
7. Balya – Strengthening tissues
8. Example: Tonics
9. Alepa – Applying medicated paste
10. Example: Herbal creams
11. Pradeha – Thick herbal paste
12. Example: Poultice therapy
13. Kalka Pradeha – Herbal plaster
14. Example: Herbal bandage
15. Ksheera Karma – Milk-based therapy
16. Example: Soothing lotions
17. Sneha Pana – Internal oil therapy
18. Example: Omega fatty acids
19. Mamsarasa – Meat soup therapy
20. Example: High-protein diet
21. Ksheerapana – Milk intake
22. Example: Nutritional milk

Group 5: Surgical Repair Stage

1. Sandhana – Joining tissues
2. Example: Suturing
3. Sutra Karma – Stitching techniques
4. Example: Surgical sutures
5. Avsadana – Suppressing excess tissue
6. Example: Treating overgrown granulation tissue
7. Avasadana – Controlling abnormal tissue
8. Example: Scar control therapy
9. Pratisarana – Rubbing medicines
10. Example: Local drug application
11. Lekhana Karma – Advanced scraping
12. Example: Surgical cleaning of chronic wounds

Group 6: Systemic Detox and Support Therapies

1. Vamana – Therapeutic vomiting
2. Example: Detox therapy (rarely used now)
3. Virechana – Controlled purgation
4. Example: Medical bowel cleansing
5. Asthapana Basti – Decoction enema
6. Example: Medicated enema
7. Anuvasana Basti – Oil enema
8. Example: Lubricating enema
9. Nasya – Nasal therapy
10. Example: Nasal drops
11. Svedana – Steam therapy
12. Example: Warm fomentation
13. Abhyanga – Oil massage
14. Example: Therapeutic massage

Group 7: After-Care and Long-Term Recovery

1. Rasayana – Rejuvenation therapy
2. Example: Antioxidant supplements
3. Vajikarana – Strength-building therapy
4. Example: Energy tonics
5. Samrakshana – Protection of healed area
6. Example: Scar protection
7. Punarnavikarana – Tissue regeneration
8. Example: Regenerative therapy
9. Upadrava Chikitsa – Treating complications
10. Example: Managing infection
11. Durgandha Nashana – Removing bad smell
12. Example: Deodorizing dressings
13. Margashodhana – Cleaning body channels
14. Example: Detox programs
15. Ropana Dravya – Healing medicines
16. Example: Antibiotic ointments
17. Prakopa Nashana – Balancing body reactions
18. Example: Anti-allergy medicines
19. Apatarpana – Reducing excess discharge
20. Example: Dry dressings
21. Yavagu – Light liquid diet
22. Example: Soft food diet
23. Pathya Ahara – Long-term healthy eating
24. Example: Balanced diet for recovery

Conclusion – Why Shasti Upakrama Is Still Relevant Today

Even in today’s world of modern hospitals and technology, doctors follow the same steps:

✔ Clean the wound

✔ Stop bleeding

✔ Remove dead tissue

✔ Prevent infection

✔ Stitch the wound

✔ Give nutritional support

This shows that Sushruta’s science was far ahead of its time and is still useful today.