It is a minimal invasive Ayurvedic Parasurgical procedure and time-tested Ayurvedic technique in the management of Anorectal disorders. It is a safe, sure and cost effective method of treatment for fistula-in-ano, haemorrhoids and other sinus diseases.

Kshar Sutra is performed by first coating a surgical linen thread of gauge number 30 with Snuhi Latex 11 times, snuhi latex and Apamarga Kshara 7 times, and snuhi latex and turmeric powder 3 times.

Those who undergo such treatment recover from the treatment in just 3-5 days after having stayed at the hospital for only 5-6 hours only 30-45 minutes of which are used to perform the surgery.

Kshara is a caustic, alkaline in nature obtained from the ashes of medicinal plants. It is a milder procedure compared to surgery and thermal cautery. ... Kshara Karma is useful as the substitute of surgical instruments, because they can be used safely on the patients who are afraid of surgery

The patient is anesthetized and a malleable probe with the surgical linen thread (called the Kshar Sutra) in its groove is passed through the external opening of the fistula to its inside and the probe is then carefully taken out with the Kshar Sutra intact. After this, both ends of the Kshar Sutra are tied together and replaced with a new one after a week. Because of this procedure, the tract is eventually cut and healed by the removal of unhealthy tissue. This controls microbial infection and facilitates drainage of pus in the tract aiding in healing.

Application of Kshara Sutra in Fistula-in-ano

The patient is anaesthetized with local or spinal or general anesthesia, then a malleable probe is passed through the external opening of the fistula to the internal opening in the anal canal and probe is gently taken out through anal opening to outside along with a Kshara Sutra in the groove of the probe. Later both ends of the Kshara Sutra is tied together. The Kshara Sutra is replaced by a new one after an interval of one week. The Kshara Sutra gradually cuts and heals the tract. Finally the whole fistulous tract heals after cutting.

Mechanism of action of Kshara Sutra in Fistula-in-ano

  1. It helps is cutting, curetting, draining and healing of the fistulous track.
  2. It destroys and removes unhealthy tissue and promotes healing of the fistulous track due to caustic action.
  3. Controls infection by the microbicidal action.
  4. Separation of debris and cleaning the wound.
  5. Facilitate in drainage of pus in fistulous tract and help in healing.
  6. Cutting through the tissues and laying the track open.