It is a chronic granulating tubular tract consisting of fibrous tissues with two opening between two cavities or cavity to cutaneous surface of the body.
Any abscess around the anus within 4.0 cm area or more than 4.0 cm area recurred may be fistula in ano as shown in fig.
It will never heal without surgical management and may recurred after that too.
Kshar Sutra Therapy is successful treatment for about common ano-rectal diseases like piles, anal fissure with or without sentinel tag,fistula in ano , rectal polyp etc.
In case of fistula in ano to take concent after the diagnosis and pathological investigations with manual and instrumental exploration done for internal opening.
Sometimes it is not exactly explored or closed due to fibrosis during conservative antibiotic or homeopathic treatment.
Then incmoplete tract of fistula in ano should be packed with a piece of Kshar Sutra.
After 2-3 days or on next visit fistulous tract again explored for internal opening with malleable silver probe with an eye at one end.
Now passing the probe into the internal opening or near the opening under the mucosa or submucosa has minimum resistant to pierce the one end of the probe.
The Kshar Sutra is anchored with other end of the probe which has an eye.
Gently probe is passed through the anus and Kshar Sutra is ligated with three consecutive knots.
All procedure is done under local anesthesia.
After cleaning the part cotton soaked with Jatyadi Tail or Anu Tail put on the part that is supported with "T" bandage or tight underwear.
After care management in which Ayurvedic drugs as Panchsakar Churna or Satsakar Churna,Abhayarista etc. and medicated oils as Jatyadi Tail or Anu Tail in the form of self retaining enema before defeacation is used, for this purpose half cut plane rubber catheter of no.7 or 8 fitted in the nosal of disposable syringe of 5ml rather than needle, the device used as self retaining enema apparatus as shown in fig.
Patient is also advised to take hot sitz bath or hip bath in a simple plastic tub filled luke warm water after defecacation for about 4-5 minutes as shown in fig.
Patient is also advised for walking 4-5 km. per day and mild work person can. Kshar Sutra is changed every week upto the cut through.
Remaining wound after cutting of last Kshar Sutra soon healed.
