Minimally Invasive Management of Pilonidal Sinus Using Kshara Sutra: A Clinical Case Study: ORIGIONAL RESEARCH  (CASE STUDY)

Dhiraj  Sharma; Ishan Parashar; Sangita

doi:10.64280/JAA.2025.V1I106

Authors

Dhiraj Sharma 1Professor, Department of Shalya Tantra, Gangasheel Ayurvedic Medical College and Hospital, Bareilly, Utter Pradesh, India 243123 Author
Ishan Parashar Assistant professor, Department of Shalya Tantra, Vaidya Yagya Dutt Sharma Ayurved Mahavidyalaya, Khurja, Utter Pradesh, India 243123 Author
Sangita Assistant Professor, Department of Rasa Shastra and Bhaisjya Kalpana, Gangasheel Ayurvedic Medical College and Hospital, Bareilly, Utter Pradesh, India 243123 Author

DOI:

https://doi.org/10.64280/JAA.2025.V1I106

Keywords:

Pilonidal sinus, Nadi Vrana, Ayurvedic surgery, Kshara Sutra therapy, Guggulu Nimba Kshara Sutra

Abstract

ABSTRACT

Background: Nadi Vrana, described in Ayurveda, refers to an ulcer with a tubular extension. Among its five types, Shalyaja Nadi Vrana is comparable to pilonidal sinus, characterized by a tract in the natal cleft region often caused by ingrown hairs (Shalya). Conventional treatments such as wide excision and reconstructive surgical techniques are associated with a high recurrence rate. The Ayurvedic approach using Kshara Sutra therapy offers a minimally invasive alternative with promising outcomes.

Aim: To evaluate the clinical efficacy of Guggulu Nimba Kshara Sutra in the management of pilonidal sinus (Shalyaja Nadi Vrana).

Case Presentation: A 28-year-old male patient presented with a painful swelling and discharge in the natal cleft region, diagnosed as pilonidal sinus. The patient was treated using Guggulu Nimba Kshara Sutra, a medicated thread prepared with Ayurvedic herbal formulations. The therapy involved gradual excision of the sinus tract through periodic tightening of the thread, promoting healing.

Outcome: Complete excision of the tract was achieved within a span of six weeks with minimal scarring. The patient experienced significant symptom relief, no recurrence during follow-up, and resumed daily activities without discomfort.

Conclusion: This case highlights the efficacy of Guggulu Nimba Kshara Sutra in managing pilonidal sinus, offering a cost-effective, minimally invasive treatment option with reduced recurrence rates and faster recovery compared to conventional methods.