title: Ksharsootra (medicated seton) treatment for fistula-in-ano.
abstract: 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.
authors.affiliation: Department of General Surgery, Seth G S Medical College, Mumbai.
authors.forename: J D
authors.initials: JD
authors.lastname: Mohite
authors.forename: R S
authors.initials: RS
authors.lastname: Gawai
authors.forename: O S
authors.initials: OS
authors.lastname: Rohondia
authors.forename: R D
authors.initials: RD
authors.lastname: Bapat
mesh_terms: 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