Kshar-sutra ligation is quite famous and result oriented procedure which involves ligation of medicated thread in fistula in ano or internal piles. Various researches have been done over this procedure. It suggests that it involves the action of excision, scrapping, penetrating, debridement and healing too. It is antiseptic also.
Kshar Sutra" (क्षारसूत्र) is a Sanskrit phrase in which Kshar (क्षार) refers to anything that is corrosive or caustic; while Sutra (सूत्र) means a thread. The Ksharsutra was first mentioned by the "Father of Surgery" Sushruta in his text named SUSHRUT - SAMHITA for the treatment of Nadi Vrana (sinus), Bhagandara (fistula- in - ano) and piles.
Kshara-sutra is a medicated thread which is prepared by applying the coatings of apamarg kshara, haridra churna with snuhi ksheer as binding agent. There are about 21 layers of medicine over it.
In case of piles, Kshar sutra is ligated around the pile mass. This pile mass shed off within 7-10 days. Along with this, herbal laxatives are prescribed to ease the motion. It is very simple procedure and bears no complication. It prevents the recurrence of the pile at the same position in the anal canal.
In case of fistula, Kshara sutra was the novel idea of drug delivery along the whole length of the fistulous tract by the ancient surgeons. During kshar-sutra therapy, there is debridement and cutting of the tissues followed by healing. The kshara selectively acts on the unhealthy tissues, and pus pockets. Then, healing starts from deeper tissues and travels towards periphery in stages. The sutra is changed after every 7 days till the full healing occurs.
The postoperative complications like recurrence, fecal incontinence and bleeding are not seen with kshara sutra treatment. Further this surgery can be performed as a minor procedure on OPD basis. No general anesthesia and hospitalization are required. Patient can maintain his/her daily routine activities as earlier. Procedure takes very less time. Ayurvedic surgeons offer better cure rates for fistula- in- ano as compared to modern surgery.
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