Application of Snuhi-apamarga ksharsutra in the management of Nadi vrana (pilonidal sinus): A case study

Pilonidal sinus (PNS) is a inflamed fibrous-granulated tract between the buttocks (natal cleft) that can cause pain, embarrassment, and employment disruption. Men are more prone than women (because of the fact that men have more hair). Due to friction between clothes and body, hairs break off and collect in cleft and further it penetrates the soft and moistened skin at that region or enters the opening of mouth of sudoriferous glands. After initial entry dermatitis and inflammation start around the loose hairs and sinus will be formed after. In modern medical science numerous surgical procedures have been described, but rate of treatment failure is high and recurrence of disease is frequent all over the world which makes it more difficult for treatment. Also, the patient requires longer hospitalization, and the procedures are expensive. Acharya Sushruta has been explained the concept of kshar sutra in the context of Nadi vrana (sinus). Kshar Sutra treatment not only minimizes complications and recurrence but also enables the patient to resume work quicker and with less discomfort, impact upon body image and self-esteem as well as reduced cost. In present study the case presenting with complaints of Pain and foul smelling discharge from low back which was diagnosed as pilonidal sinus, not willing to undergo surgery and opted for the kshar sutra.