Out of many treatment options for pilonidal sinus, Kshar Sutra Therapy is the most preferred because of high success rates, no complications and very low recurrences. A lot of patients are getting cured through this ayurvedic para-surgical technique from around the globe. Here we try to give an overview about this treatment for pilonidal sinus.

How Kshar Sutra Therapy is done in

Pilonidal Sinus

  • Preparation of affected area

    You are made to lie on your stomach and affected area is cleaned using medicated solutions. Surrounding hair are being shaved. Proper anaesthesia is given to make the area numb. Most of the times a local anaesthesia is sufficient. In complicated cases, your doctor may suggest you to choose for general anaesthesia.

  • Exploring the track

    After proper anaesthesia, sinus track and the branches are carefully explored using specially designed probes. This helps in assessing the extent of pilonidal sinus track.

  • Removal of hair from the sinus

    A pilonidal sinus contains a lot of hair that need to be removed. All the hair is removed manually using suitable instruments. Any left-out hair will spontaneously come out gradually during the treatment course.

  • Cleaning of sinus track

    Track walls are cleaned using medicated solutions and herbal pastes (kshar paste) to ensure adequate infection removal and wound cleaning.

  • Putting Kshar Sutra (The alkaline thread) in the sinus cavity

    As per the requirement, one or more kshar sutra is put in the track/tracks. This thread is medicated and helps in herbal cauterisation of the track. This is followed by a wound dressing.

  • Weekly change of Kshar Sutra till it comes out by itself.

    Medicines on the thread fades away within 3-4 days and the thread becomes inactive. This old kshar sutra is replaced by a fresh Kshar Sutra every week. Number of weeks depend upon the length and depth of track.

Post Kshar Sutra Therapy Instructions

Post Therapy Instructions

  • Maintain hygiene
  • Sitz bath to be done after each bowel movement.
  • Proper wound dressings.
  • Take nutritious foods and avoid fast foods.
  • Make weekly visits to the doctor for thread change.

General advices

Post Therapy medicine coverage

  • For infection control
  • Faster healing
  • Better wound care
  • Treating any other medical condition like diabetes, hypertension etc

Treatment Day

What will happen when you arrive at the hospital on the day of therapy

  1. Review of papers
  2. Re-examination of affected region
  3. Vitals check – Temperature, BP, Pulse etc
  4. Random Blood sugar
  5. Consent signature
  6. Therapy
    • Takes only 30 minutes
    • No pain
    • No hospital admission required
  7. Will be able to go home on the same day (usually after 60-120 minutes)

5 Stages of Pilonidal Sinus Treatment

  • Stage 1

    Infection Drainage

    First 2-3 weeks

  • Stage 2

    Slow Cutting

    3rd week onwards

  • Stage 3

    Gradual Healing

    4th week onwards

  • Stage 4

    Cut Through

    after 5-10 weeks

  • Stage 5

    Wound Healing

    After cut through of Kshar Sutra

*Approximate durations. May differ in different patients.

Mode of Action of Kshar Sutra in Pilonidal Sinus

  1. Herbal alkaline medicines present on Kshar Sutra acts by Herbal Cauterisation.
  2. It removes all the infection from the sinus track. Infection is extracted from any hidden track or branches also.
  3. Medicines on Kshar Sutra and mechanical pressure by the thread results in slow cutting of the track making the track shorter each time we change the thread.
  4. Track continues to shorten and healed from behind at the same time.
  5. After a few days the Kshar Sutra cuts off by itself leaving behind a small wound.
  6. Kshar paste is applied on this wound to ensure proper wound healing.

Kshar Sutra Therapy in Pilonidal Sinus

All videos on Pilonidal Sinus

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How to recover fast

Things that you can do for faster recovery

  • To let the wound heal faster and recover well, you are supposed to do following things: • Never leave the wound open for too long, always keep a dressing on it.
    • Keep your dressing clean and dry.
    • Frequently change your dressing as instructed by your doctor and as needed if it becomes soiled in pus or blood or falls off.
    • Quit smoking.
    • Take a nutritious diet and avoid fast foods.
    • Take your medications as instructed by your doctor.
    • Keep your blood sugars in control (if you have diabetes).
    • Maintain a healthy weight.
    • Shower or bath daily and more often if you are sweating (and after bowel movements)
    • Remove the dressing before shower, clean the area using your hand-held shower head and then make sure to gently pat the pilonidal sinus area dry (don’t aggressively rub the wound).
    • Do proper dressing as advised by your doctor.
    • Avoid too much driving and sitting.

Frequently asked questions

Will I be in pain?

This is not a painless treatment. You should expect some discomfort during the treatment duration. You’ll be able to do all your daily routine work without any problem. Keeping a dressing pad on the affected region would help in preventing pain caused by pressure.

Do I need to take medicines?

Yes, you’ll be advised to take a few herbal medicines to let the wound heal properly. You may need medicinal support for any other medical condition e.g., diabetes, hypertension etc. Regular dressings can be easily managed by the patient himself.

How much time is required for complete recovery?

It varies in different individuals and depends on many factors. Many patients take 5-6 weeks while a few may take more than 15 weeks for complete recovery. Ask your consulting doctor about it. Always remember that slow healing of the wound is better for the future as it minimizes the chances of recurrence.

Is it fine if I do not do sitz bath?

Sitz bath is considered to be an essential part of the pilonidal sinus treatment as it helps in maintaining hygiene and prevents infection. Do not neglect this important post-therapy instruction, if you want to stay away from pilonidal sinus.

Benefits

Benefits of Kshar Sutra Therapy in Pilonidal Sinus

Kshar Sutra Therapy is the most recommended treatment in Pilonidal Sinus because –

How to minimize the risk of recurrence?

Although the recurrence rate after Kshar Sutra Treatment for Pilonidal Sinus is very less, still there are always some chances. The most important measure to prevent recurrence of pilonidal disease is regular shaving or removal of hair from the buttock cleft area and keeping it free of hair for 6-12 months after the wound is healed. To reduce the chances of recurrence everyone should follow following measures:

  1. Keep the affected area clean.
  2. Keep the affected area free from hair.
  3. You may opt for permanent hair removal through laser.
  4. Maintain undergarments hygiene.
  5. Keep doing sitz bath once or twice a week.
  6. Avoid too much sitting and long driving for at least 12 months.

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