• The surgeon should treat by scraping those hard ulcerative lesions with thick rolled margis, which have a tendency to crack repeatedly, and have hard and raised granulating surface. 
   
• Method of Scraping
  • Scraping should be done uniformly, and it (the lesion) should be scraped well; scraping should leave no pockets uncleared, and the margins should be scraped well by an appropriate sharp instrument to make them level. 
    
• Material for Scraping
  • Ksauma, plota, picu, phena, yava-ksara with rock salt and leaves possessing rough surfaces should be used for scraping. 

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• The surgeon should gently probe the sinuses, wounds with foreign bodies, unmargi fistulae-in-ano and tracks with the help of tender bamboo sprouts, hairs, fingers or probes.
• Bleeding sinuses with narrow openings in the viscinity of the eyes and the anus should be probed by the fine stems of cuccu, upodika and karira.

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• When indications for extraction of the foreign body become evident, it should be removed from the wound with either a narrow or a wide opening  

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• For the diseases amenable to treatment with drainage by puncturing, the same should be done by the sharp instrument at the proper site and (by a puncture) of an adequate size for effectively draining out the dosas (pus with foreign body).

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• Union by suturing is indicated for the wounds, which are widely gaping, involve the muscles and are uncomplicated by infection (suppuration).

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• Trimming of the uneven edges of a wound for proper suturing.

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• Drainage with the help of squeezing by an application of the paste of pidana drugs mentioned earlier is indicated for abscesses with small openings and for those lesions, which have involved the vulnerable areas. 
• For the purposes of pidana, the paste should be allowed to get dry; the (wound) opening should not be covered by the paste so as to allow the dosas (pus) to come out. 

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• When there is excessive haemorrhage due to its various aetiological factors, haemostasis is achieved 

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• Nirvapana (cooling) measures are indicated for the lesions, caused by vitiated pitta, which are engorged with blood, are associated with burning sensation, suppuration and fever.
• The drugs possessing cooling properties should be pasted in milk and processed with ghrta and should then be sued with plenty of cold irrigations (prepared from the same drugs).

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• Utkarika (warming) measures are indicated for non-suppurative, poorly granulating, hard and rough ulcerative lesions with scanty discharge and associated with pain of pricking and spasmodic nature and throbbing. 
• Utkarika is prepared from the drugs having vata pacifying qualities, drugs of sour group, as well as of kakoli group and mixed with oil seeds and then cooked in the form of a paste. Fomentation by the utkarika (poultice) thus prepared is effective for indurated and painful (lesions).

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• Cleansing (medicinal Debridement) by decoctions of Sodhana drugs, is specifically indicated for the foul smelling, sodden and slimy wounds. 

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• Use of medicated wicks containing sadhana drugs ,is indicated for removing foreign bodies deeply embedded in the muscles and where the wound has a very small opening. 

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• Cleansing (medicinal Debridement) by medicated pastes, prepared from the appropriate drugs for making wicks is indicated for ulcerative lesions covered with putrefied flesh and associated with vitiated and aggravated dosas. 

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• Ulcers afflicted by vitiated pitta, which are deep and associated with burning sensation and suppuration should be treated successfully by (medicinal Debridement with) (cleansing) ghrta processed with cottonseeds and Sodhana drugs. 

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• Dry ulcers with hypertrophied granulation tissue, and with insignificant discharge should be cleansed (medicinal Debridement done) by mustard oil processed with drugs mentioned earlier.

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