Management of Pilonidal Sinus with Chedana Karma and Apamarga Kshara Pratisarana

Abstract

A Pilonidal sinus (also called as pilonidal cyst, pilonidal disease, or sacrococcygeal fistula) is a small tunnel or tract that forms under the skin, usually near the top of buttocks (in the natal cleft, just above the tailbone). It often results from ingrown hairs, which lead to a cyst or abscess forming under the skin. Male gender is more affected than females with a 4:1 preponderance. Obesity, friction or prolonged sitting, excessive body hair, poor hygiene, young age is some of its risk factors. Acharya Sushruta in Nidana Sthana 10^th chapter has described Nadi Vrana where one of its sub types, Shalyaja Nadi Vrana resembles in cause, pathology and clinical symptoms to pilonidal sinus. Chedana karma along with the removal of Shalya, that is, hair tuft is a gold standard for the management of the disease. A 26 years old male patient came to Shalya OPD with complaints of swelling, pain and blood mixed pus discharge from the wound present in sacrococcygeal region for last 2 months. The case was managed successfully with Chedana karma followed by Apamarga kshara Pratisarana and within 2 months, the wound was healed completely.