Abstract

MANAGEMENT OF PILONIDAL SINUS WITH UDUMBARA KSHEERSUTRA- A CASE STUDY

Dr. Rashmi Bharti* and Kalmegh M. S.

Abstract

Introduction: Pilonidal Sinus is an infected tract under the skin between the buttocks (the natal cleft) which goes in vertical direction and commonly contains hairs. The most commonly used surgical technique include excision with primary closure and excision with reconstructive flap. However, the risk of recurrence or of developing an infection of the wound after the operation is high. Also, the patient requires longer hospitalization, and the procedure is expensive. There is similarity between Shalyaj Nadi Vrana described in Sushrut Samhita and Pilonidal sinus. Sushruta has advocated a minimally invasive parasurgical treatment, viz., Ksheer Sutra procedure, for nadi vrana. Hence, this therapy was applied in this case of Pilonidal Sinus, and is described in the case report. Aim & Objectives: 1. To find a minimally invasive technique of treatment in Pilonidal Sinus in a male patient of 26yrs by a non-surgical method. 2. To study the effectiveness of Udumbara Ksheersutra in Pilonidal sinus. Material & Methods: Ksheer sutra threading was done on clinically diagnosed patient of Pilonidal sinus with 3 openings and was advised for changing ksheerasutra every 7th day by Railroad technique until “cut through” of the tract. Results: The patient recovered well with complete excision of tract within span of 15 weeks with no recurrence and irritation. Conclusion: The results obtained were found to be very encouraging as it minimizes the rate of complications and recurrence, and enables the patient to resume work and normal social activities very early. Hence, application of udumbara ksheer sutra can be effective intervention in the management of Pilonidal Sinus.

Keywords: Pilonidal sinus, nadi vrana, udumbar ksheer sutra.