Management of recurrent anterior Perineal Sinus by Ksharsutra- A case report

Abstract

Introduction: Ksharasutra therapy is long known for effectively treating Sinus infections (Nadi Vrana). It has been mentioned in various Ayurvedic classical texts like Sushrutha Samhita, Chakradatta etc. Ksaharsutra as a standard treatment method has been extended to various types of sinus or fistulas with encouraging results. This case has been taken up evaluate the role of Ksharsutra as a minimal invasive method in management of recurrent anterior perineal sinus. 

Clinical Findings- A 28 yr old male with history of sinus in perineum who has already been operated twice for same disease with an active pus discharge, discomfort and itching.

Diagnosis/Methodology/Therapeutic Intervention-The case had already been diagnosed for perineal sinus by MRI sonogram.Under local anesthesia with Lignocaine 2% was given in perineum. Copper malleable probes were introduced through two different external openings. The front end of the probe was pulled through an artificially made openings using an electric cautery. Two Ksharasutras were placed in 2 tracks with the help of these probes. Both Ksharsutra were knotted and changed weekly once.

Results/ Outcome- Cut through for smaller tack was achieved in 4 weeks and longer sinus track took 8 weeks to cut through. No recurrence was observed during 6 months and 1 year follow ups.

Conclusion/Takeaway- Ksharsutra as a minimally invasive procedure is very effective and convenient method for recurrent perineal fistulas and sinuses which gives tremendous and lasting results without interfering day to day work schedule of the patient.