Analysis of efficiency and pain level in the management of Fistula-in-Ano with sliding Ksharasutra technique - A case series

Ksharasutra therapy is an ancient Ayurvedic treatment utilized in the management of Fistula-in-Ano. This study explores the efficiency of a novel sliding Ksharasutra technique to enhance the effectiveness of the treatment and patient comfort. The square knot of the Ksharasutra is replaced with a sliding knot which allow easier adjustments in the tension of the thread. This method was applied to seven patients, and the cutting rate was assessed in centimeters and pain levels were measured using the Visual Analogue Scale (VAS). Results demonstrated a remarkable increase in the cutting rate, up to 1.98 cm per week, when compared to the conventional method. Additionally, the novel sliding technique was able to substantially reduce the pain during thread changes. The results suggest that the sliding Ksharasutra technique can accelerates the cutting rate as well as improves the patient comfort by reducing the pain during the course of treatment. This approach offers a potential superior alternative to the conventional methods.