Ksharsootra (medicated seton) treatment for fistula-in-ano.
BACKGROUND
Recurrence and incontinence are common after conventional surgery for fistula-in-ano. Medicated seton (ksharsootra) is a time-tested therapy.


METHODS
Seton treatment was given to 114 patients with anal fistulae. The initial loose seton was changed weekly to achieve fistulotomy.


RESULTS
Application of non-medicated seton did not show any cutting action; hence all patients were treated with ksharsootra after 3 weeks. Anal discharge (n = 114) and burning pain (35) were noted in the first 48-72 hours. The cut-out rate was around 1 cm/week, with mean cut-out time 8.3 weeks (range 3-18). All wounds healed well and patients remained ambulatory. Local induration developed in 18 patients; four had an abscess. There was no incontinence or recurrence over a follow-up of 6 months to 2 1/2 years.


CONCLUSIONS
Ksharsootra treatment for anal fistulae is safe and effective, with low complication rates.
Mohite
J D
JD
Department of General Surgery, Seth G S Medical College, Mumbai.
Gawai
R S
RS
Rohondia
O S
OS
Bapat
R D
RD
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008515:Medicine, Ayurvedic; D008875:Middle Aged; D008517:Phytotherapy; D012003:Rectal Fistula / Q000175:diagnosis / Q000628:therapy*; D012189:Retrospective Studies; D012449:Safety; D013536:Suture Techniques; D016896:Treatment Outcome; D014945:Wound Healing