Minimal Invasive Surgical Treatment of Recurrent Pilonidal Sinus – A Case Report
DOI:
https://doi.org/10.70066/jahm.v14i2.2493Keywords:
Case report, Ksharasutra ligation, Nadivrana, Pilonidal sinus.Abstract
Background: Pilonidal sinus or jeep disease is considered an acquired one, which involves the formation of a sinus tract and pus is draining to it. The etiology is thought to be related to trapping of hair. Nadi vrana, which is explained in Ayurveda, is a blind tract in which pus is formed. It is mentioned in Samhithas that, if vranasopha is not treated in pakva avastha (suppurative stage) by neglecting it, it will traverse to the deeper tissues, forming a tract. By understanding the nidanas (etiological factors) and lakshanas (clinical features) it can be correlated as shalyaja Nadivrana. Ksharasutra is one of the unique contributions in Ayurveda, by which it cures through its chedana, bhedana, and lekhana properties. Clinical Findings: A 24-year-old male presented with chief complaints of pain and swelling in the supranatal cleft and lower back region and after examination, was diagnosed with a recurrent pilonidal abscess. He had a history of similar complaints and underwent incision and drainage twice within an interval of 2 months. Intervention: Topical Lepana was performed, followed by surgical incision, sinus tract probing, and Ksharasutra ligation of the sinus tract. Postoperatively, the patient was managed with Ayurvedic internal medications, sitz bath, and medicated dressings. Outcomes: Healing was achieved with reduced wound size, healthy granulation tissue, and epithelialization, obliteration of 8 cm sinus tract and without any recurrence in a duration of 45 days of treatment and 2 months of follow-ups. Conclusion: Minimally invasive ksharasutra ligation along with supportive therapy, dietary and lifestyle measures and standard wound care, effectively managed recurrent pilonidal sinus, achieved complete healing in 45 days with no recurrence. This case represents a safe, cost-effective alternative to conventional surgery. The procedure not only minimizes the recurrence rate but also helps the patient to recover quickly with less discomfort.
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