Dr Dwivedi's Speciality Ano-Rectal Clinic

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Kshar Sutra

What is Kshar Sutra ?

It is medicated thread(Seton) coated with herbal alkaline drugs.

Application of Kshar sutra

  • Proper pre- operative measures like Pre- op medication, preparation of part, shaving and bowel preparation (enema) is given.
  • Reconfirmation of daignosis and Proctoscopy is done in the ward.
  • Lithotomy position is given to the patient.
  • Anesthesia depends on patient's fitness and conditions
  • With specially designed probe and aseptic precautions insertion of kshar sutra from external opening to the internal opening coming from anal verge and tying loose ends like Seton technique.
  • Dressing with medicated oil
  • Weekly changing of thread is advisable by ‘Rail-Road’ technique.

Kshar sutra Ligature Technique

  • Direct reference is found in Charak samhita whereas in Sushrut samhita, guideline regarding this is found while discussing the Nadi vran chikitsa.
  • However, with some modification his technique exists today in India, Sri Lanka,Nepal, Japan, China.

Advantages of Kshar sutra Treatment

  • It’s a Day care procedure
  • Usually can be performed without anesthesia (specially low level fistulas)
  • Avoid incontinence and bleeding
  • It minimizes the pain, which could be tolerable
  • Most effective and Safe with high cure rate.
  • Cures all type of fistulas and Cost effective.
  • Early ambulation and Reduces hospital stay.
  • Patient can get rid of post op. daily painful dressing .
  • Avoid anal stricture and structural deformity.
  • Comparatively very low recurrence rate.
  • Can be done even in pateints with systemic disorders like Tuberculosis, Diabetes Mellitus, Hypertension, Anaemia, Ischemic Heart Disease, Paraplegia,Chron’s disease, Colitis and HIV with proper precautions

How does it works ?

The Ksharsutra helps in Debridement and Lysis of the tissues Antifungal, Anti bacterial, and Anti Microbial Produces a running sore, Anti inflammatory Destroy residual glands epithelium.
Siimultaneous Cutting and Healing of Sphinters.
Simultaneous cutting and healing of the fistula track occurs which avoid recurrence and sphincteric complications which otherwise can cause incontinence.
In simple way if we give pressure to wire on ice block it passes through it but doesn’t divides the ice.