A Systematic Review of Modifications in Preparation of Ksharasutra and Its Application Techniques in Patients of Bhagandara (Fistula-in-Ano)

Abstract

Bhagandara (Fistula-in-ano) is well known cause of morbidity in all ages, gender and socio-economic status which has a promising treatment available with Ayurvedic practice of Ksharasutra (medicated setons). This is proven to have relatively lower rates of complications and recurrences. The standardised form of Apamarg Ksharasutra (Snuhi, Apamarg and Haridra churan) is been used for long and still considered the gold standard. However, difficulty in procurement, non-perennial availability of few of its constituents and challenging technique especially in complex cases has always encouraged the practitioners and researchers to come up with trial of other ingredients as per old literature like Sushruta Samhita and to modify the application techniques. This is an endeavour to venture into literature and compile such promising efforts.