Introduction to Kshara Sutra Therapy
Kshara Sutra therapy is a minimally invasive Ayurvedic parasurgical procedure widely used for the management of anorectal disorders. With its roots in ancient Ayurvedic texts like those of Sushruta, Charak, and Vagbhata, this therapy has been validated through scientific research conducted by institutions like Banaras Hindu University, CCRAS, and ICMR. It is recognized as a safe, effective, and cost-efficient treatment method for conditions such as fistula-in-ano, hemorrhoids, pilonidal sinus, and others.
Preparation of Kshara Sutra:
The standard Kshara Sutra is prepared by coating a thread with layers of Snuhi latex (Euphorbia nerifolia), Apamarga Kshara (Achyranthes aspera), and Haridra Churna (Curcuma longum). The pH of Apamarga Kshara Sutra is 9.72.
Indications:
- Fistula-in-ano
- Hemorrhoids
- Sentinel piles
- Pilonidal sinus
- Rectal or anal polyps
- Warts, etc.
Application of Kshara Sutra:
- Fistula-in-ano:
- Anesthesia is administered.
- A malleable probe carrying the Kshara Sutra is passed from the external to internal opening of the fistula tract.
- Both ends of the Kshara Sutra are tied together.
- The Kshara Sutra is replaced weekly, gradually cutting and healing the fistulous tract.
- Hemorrhoids:
- Local anesthesia is administered.
- Pile mass is brought out and incised at the mucocutaneous junction.
- Kshara Sutra is tied at the base of the pile mass, leading to chemical cauterization and mechanical strangulation.
- The resulting wound heals within 10-15 days.
- Pilonidal Sinus:
- Local anesthesia is administered.
- A malleable probe carrying the Kshara Sutra is passed through the external opening of the sinus tract.
- Both ends of the Kshara Sutra are tied together, and the process is repeated weekly.
Mechanism of Action:
- Cutting, curetting, draining, and healing of the tract.
- Destruction of unhealthy tissue through caustic action.
- Microbicidal action to control infection.
- Facilitation of pus drainage and tissue healing.
Advantages of Kshara Sutra Therapy:
- Simple, safe, and cost-effective.
- Minimal recurrence rate.
- Can be performed on patients with systemic diseases.
- Minimal surgical complications such as incontinence, stenosis, or stricture.
Kshara Sutra therapy stands as a testament to the efficacy of Ayurvedic principles in addressing complex medical conditions with minimal invasiveness and maximum effectiveness.
