Two External Washing Formulas from the Affiliated Hospital of Shandong University of TCM for Skin Ulcers, Bedsores and Chronic Leg Ulcers

The Affiliated Hospital of Shandong University of Traditional Chinese Medicine has two fumigation-washing formulas for treating sores and ulcers, bedsores and ecthyma (chronic leg ulcers). These two formulas are reasonably composed and have definite efficacy; they are introduced here for readers' reference.

Formula 1: Jiedu Xi Yao (Detoxifying Wash)

Composition: Pugongying (Taraxacum) 30 g; Kushen (Sophora flavescens), Huangbo (Phellodendron), Lianqiao (Forsythia), and Mubiezi (Momordica), 12 g each; Jinyinhua (Lonicera), Baizhi (Angelica dahurica), Chishao (Paeonia rubra), Danshen (Salvia), and Sheng Gancao (raw licorice), 9 g each.

This formula has the actions of clearing heat and detoxifying, activating blood and reducing swelling, and removing necrosis and draining pus. It mainly treats the early and post-ulceration stages of yang-type sores, traumatic infection with toxin, superficial thrombophlebitis, gangrene of the extremity, ecthyma, and purulent skin diseases presenting with redness, swelling, heat, pain and profuse pus.

Usage: Decoct the above herbs in 1500 ml of water, then fumigate the affected area; once the solution has warmed to a comfortable temperature, apply it by soaking, pouring, sitz bathing or warm compress to the affected area as clinically required, 1-2 times daily for 30 minutes each time. After fumigation-washing, wounds should be routinely cleaned and redressed.

Formula 2: Jiedu Qufu Xi Yao (Detoxifying and Necrosis-Removing Wash)

Composition: Danggui (Angelica sinensis), Baizhi (Angelica dahurica), Shengdihuang (raw Rehmannia), Jinyinhua (Lonicera), Aiye (mugwort leaf), Chishao (Paeonia rubra), Danshen (Salvia), Sheng Huangqi (raw Astragalus), and Pugongying (Taraxacum), 15 g each; Shuichangpu (Acorus gramineus), Chao Ruxiang (stir-fried Olibanum), and Chao Moyao (stir-fried Myrrh), 9 g each.

This formula has the actions of clearing heat and detoxifying, activating blood and resolving stasis, removing necrosis and draining pus, and generating flesh and closing the wound. It mainly treats post-ulceration sores, bedsores, ecthyma, gangrene of the extremity and burns where pus and necrosis have not detached, granulation tissue is not fresh, new flesh has not grown, and the wound color is purplish-dark. It should be noted that when treating gangrene of the extremity (diabetic foot or vasculitis), the temperature of the solution should not be too hot; lukewarm is best, otherwise it may aggravate the consumption of qi and blood at the affected area and worsen the condition.

Fumigation-washing preparations are one of the commonly used dosage forms in TCM, and red, swollen, ulcerated skin is a common clinical problem. Purulent skin infections, diabetic foot, vasculitis, and even skin corrosion from extravasated chemotherapeutic drugs can all cause redness, swelling and ulceration.

For such patients, fumigation-washing preparations act directly on the affected area, taking effect faster than oral preparations; moreover, the drugs do not undergo hepatic metabolism and have fewer side effects, making fumigation-washing preparations more advantageous.