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Kshar Sutra

Among the different branches of Ayurveda, Shalya Tantra has its own place. This branch of Ayurveda deals with those disorders which require surgical interventions at some stage of the disease. Among the Ayurvedic texts “Sushrut Samhita” originally written by Acharya Sushrut forms the main basis of surgical knowledge which is beneficial and practiced till today. The technique of fistula treatment using kshar sutra is also mentioned in Sushrut Samhita and practiced by the Ayurveda experts for curing piles / bhagandra / pilonidal sinus.

Dayanand Ayurvedic College has a full-flashed, Department which is carrying as the work related to surgical disorders incorporating the modern surgical knowledge.

Kshar Sutra

Kshar sutra therapy is a minimal invasive ayurvedic parasurgical procedure and time tested Ayurvedic techniques in the managements of anorectal disorders. It is safe, minimal recurrence rate and cost effective method of treatment for fistula in Ano, Haemorrhoid, Pilonidal sinus etc. Though the therapy has been described in detail in Ayurveda by Sushruta, Charak and Vagbhata but the efficacy of the therapy was reestablished by different Ayurvedic practitioner and scholars from time to time.

Preparation of Kshar Sutra

The standard kshar sutra is prepared by 11 coatings of snuhi latex (Euphorbia nerifolia), 7 coatings of snuhi latex and apamarga kshara(Achyranthes aspera)and last 3 coatings of snuhi latex and haridra churna(Curcuma longa).

Indications

• Fistula in Ano
• Haemorrhoids
• Pilonidal sinus
• Sentinel pile
• Rectal or Anal Polyps
• Warts, Pedunculated skin growths etc

Advantages of Kshar sutra therapy

1. Simple and safe parasurgical procedure
2. Minimal hospital stay
3. Patient remain ambulatory during treatment
4. Minimal recurrence rate
5. No surgical complication like incontinence, stenosis and stricture.
6. It is cost effective treatment.

Kshar Sutra in Fistula treatment

Application

The patient is anaesthetised with local or spinal or general anaesthesia, then a malleable probe is passed through the external opening of the fistula to the internal opening in the anal canal and probe is gently taken out through anal opening to outside along with a Ksahrsutra in the groove of the probe. Later both ends of the ksharsutra tied together. The ksharsutra is replaced by a new kshar sutra after an interval of 10 days. The Kshar sutra gradually cuts and heal the tract. Finally the whole fistulous tract heals after cutting.

Mechanism of actions

  1. It helps in cutting , curetting ,draining and healing of fistulous tract.
  2. It destroys and remove unhealthy tissue and promotes healing of fistulous tract.
  3. It controls infection by microbicidal action
  4. Separation of debris and cleaning of the wound
  5. It facilitate in drainage of pus in fistulous tract and helps in healing.
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Kshar Sutra in Haemorrhoids

Application

The patient is anaesthetized with local anaesthesia. First pile mass is holded with pile holding forceps and bring them out of the Anal orifice, then give incision at mucocutaneous junction. Later slight pull exerted over the pile mass and transfixed by kshar sutra at the base. Ligated pile mass replaced inside the rectum and rectal pack with yastimadhu talia & ghrita.

Mechanism of actions

  1. Chemical cauterisation and mechanical strangulation vessel .
  2. Local gangrene of the pile mass tissue.
  3. Ischaemic necrosis and debridement of unhealthy tissue.
  4. Sloughing of the mass with in 7-10 days.
  5. Healing of the resulting wound take place in 13-15 days.

Kshar Sutra in Pilonidal sinus

Application

The patient is anaesthelized with proper anaesthesia and then a malleable probe with kshar sutra is passed though the opening of pilonidal sinus to the skin.Later both ends of kshar sutra is tied together. The kshar sutra is replaced by a new one after an interval of 10 days. The kshar sutra gradually cuts and heals the sinus tract.

Mechanism of actions

  1. It helps in cutting , curetting ,draining and healing of sinus tract.
  2. It destroys and remove unhealthy tissue and promotes healing of sinus tract.
  3. It controls infection by microbicidal action.
  4. Separation of debris and cleaning of the wound .
  5. It facilitate in drainage of pus in sinus tract and helps in healing.

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