Kshara Sutra application in Fistula in ano (Bhagandara)

By Dr Raghuram YS MD(Ayu).
The patient is administered with anaesthesia. It can be local or spinal or general anaesthesia.
Following anaesthesia, a malleable probe is passed through the external opening of the fistula to the internal opening of the fistula located in the anal canal.

The probe is gently taken out through the inner anal opening to outside along with kshara sutra. The kshara sutra is fitted in the groove of the probe inserted into the tract of the fistula.

Both the ends of kshara sutra (alkali thread) i.e. one end in the external opening and the other end at the internal opening of the fistula are tied together.
Read related: Bhagandara – Fistula-in-ano or anal fistula

The kshara sutra is left in place and the patient discharged. After one week the old kshara sutra is replaced by a new one. Change of kshara sutra enhances teh effectiveness of the treatment and the fistula will be healed in quick time.

Over a period of time (during its application), the kshara sutra gradually cuts the tract of bhagandara and eventually heals it. Finally the whole fistula gets cut and healed.
Read related: Ksharasutra Preparation Method: Detailed Explanation

Ksharasutra Mode of action

Probable mode of action of Kshara Sutra in Bhagandara (fistula-in-ano) –

• Kshara sutra cuts, curettes, drains and heals the fistula and its tract
• Owing to its alkali and caustic action, kshara sutra destroys and removes unhealthy tissue, promotes healing of the tract of fistula
• Owing to its microbicidal and antibiotic property, kshara sutra helps in controlling and curing the infection associated with fistula
• Kshara sutra helps in separation of debris from the fistula tract
• Kshara sutra helps clean the wound or fistula
• Kshara Sutra facilitates pus drainage from fistula tract and thus helps in its healing
• It helps in cutting through the tissues and laying the track open
• Read related: KsharaSutra Pradhana Karma – Main Procedure

Ksharasutra in Nadi vrana

Administration of Kshara Sutra in Nadi Vrana (Pilonidal sinus) –

• The procedure is done in a similar way as explained in the context of bhagandara above.
• The patient is firstly administered with local anaesthesia. Following this, a malleable probe fit with kshara sutra is gently passed through the external opening of nadi vrana or pilonidal sinus to the skin. Later both ends of the kshara sutra are tied together. The kshara sutra is replaced by a new one after one week time. The kshara sutra gradually cuts and heals the sinus tract.
  Click to consult Dr Raghuram MD (Ayu)