Effectiveness of Arka Ksheer–based Kshar Sutra in the Management of Nadi Vrana: A Case Study

Pilonidal sinus is a chronic condition of the sacrococcygeal region that can be correlated with Shalyaja Nadi Vrana described in Ayurveda. It is considered a type of Dushta Vrana, wherein a sinus tract develops due to the lodgment of hair acting as a foreign body, leading to persistent infection and discharge. The condition often shows a tendency for chronicity with intermittent episodes of acute inflammation if not managed properly. Classical Ayurvedic texts emphasize the role of Ksharasutra therapy in the effective management of Nadi Vrana. The present case report describes a 25-year-old male patient who presented with complaints of pain, purulent discharge, slough formation, foul smell, swelling, and discoloration of skin in the natal cleft region, with a duration of three months. The patient was treated with Arka Ksheera–based Yavakshara Sutra, a modified medicated thread therapy. Gradual excision and healing of the sinus tract were achieved with minimal tissue damage and satisfactory cosmetic outcome, without recurrence during the follow-up period.