Successful Treatment and Prevention of Pilonidal Sinus Recurrence Through Integrative Approach

ABSTRACT Pilonidal sinus (PNS) is considered an acquired, infective condition often involving foreign body reaction, which closely resembles Shalyajanya Nadi vrana as per Acharya Sushruta . It commonly afflicts individuals in their 2 nd and 3 rd decades of life and notably prevalent among heavy motor vehicle drivers. The optimal treatment remains excision of the sinus tract; however, recurrence is frequent due to incomplete identification and drainage of the sinus tract, residual hair, or inadequate post-operative care. Here, we are reporting the case of a 22-year-old male with a 2-year history of pain, swelling, and intermittent pus discharge from the lower back (Natal cleft). He was diagnosed with a case of Shalyaja Nadivrana (PNS). He was managed using an integrative approach combining Chedana (excision) of Nadivrana (sinus) and regular post-operative wound care with Panchvalkal Kwath and Panchvalkal Malhara for topical application. Complete healing was observed within 45 days, and no recurrence was noted in 1 year follow-up period. This case highlights the effectiveness of an integrative approach in managing Shalyaja Nadivrana and in preventing its recurrence.