A Case Report on Pilonidal Sinus (Nadi Vrana) Managed Successfully with Apamarga Ksharsutra

Abstract

Pilonidal sinus (Nadi Vrana) is a chronic inflammatory illness that often affects the sacrococcygeal area, characterized by a blind tract harboring hair and debris. In Ayurveda, it resembles Shalyaja Nadi Vrana—a sinus induced by the lodging of foreign material (shalya). Though current surgical methods like extensive excision and flap repair are regularly performed, they often result in protracted recovery and high recurrence rates. Ksharsutra treatment, a minimally invasive Ayurvedic parasurgical method, has proven to be a safe and successful alternative. Here, we show a case of recurrent pilonidal sinus successfully handled with Apamarga Ksharsutra (alkaline thread derived from Achyranthes aspera), demonstrating its efficacy in encouraging controlled debridement, drainage, and healing with little scarring.