Kshara Sutra is a Sanskrit phrase in which kshara refers to anything that is corrosive or caustic, while sutra means a yarn or thread. It is described in one of the most ancient medicine known to mankind, that is - Ayurved.

The Ksharasutra was first mentioned by the "Father of Surgery" Sushruta in his text named SUSHRUT - SAMHITA for the treatment of Nadi Vrana (sinus), Bhagandara (fistula- in - ano), arbuda (excision of small benign tumour) etc. It was Chakrapani Dutta in late eleventh century in his book Chakradatta who first mentioned the method of preparation with a clear-cut indication of its use in bhagandara and arsha (haemorrhoid).

Gujarat Ayurved University, Jamnagar had done the extension of Kshara-sutra usage in other ano-rectal conditions like Piles (hemorrhoids), Chronic Fissure-in-ano with sentinal tags and other benign growths.

Mode of action

Kshar Sutra is now a popular treatment modality in India for the management of fistula in ano. Many clinical trials have been done all over in different institutes to evaluate the action.

In countries like Srilanka and Japan also many clinical trials have established its action. Precisely the action of Kshar sutra is thought to be due to its healing and cleansing effect according to Ayurveda. It can be suggested that due to the anti microbial action, and as a saton it allows the proper drainage of pus from the fistula, that leads to a proper healing.

On the other hand the cutting effect of thread incises the skin gradually without a surgical incision. Many studies confirm that it is more effective in the way of reducing hospital stay and less infection than the conventional seton therapy.

Researches suggests that it is having the action of excision, scrapping, draining penetrating, debridement, sclerosing, healing. It is bactericidal and bacteriostatic.

Types

In the textual reference of Chakradatta and Rasatarangini we get only indication of the thread made up of Snuhi, apamarga and Turmeric. Susruta describes about many kind of Kshars like Karaveera, Palasa, Kadali etc. in Susruta Samhita.

So many studies have already carried out with variations in the Kshara and the latex. The most remarkable are Guggulu Ksharasutra, Udumbara KS, Gomutra KS, Papaya KS, KS with Ficus carica latex etc.