Kshara Sutra for Pilonidal Sinus: A Narrative Review of Recurrence, Healing, Pain and Quality of Life

Pilonidal sinus is a chronic inflammatory condition of the natal cleft that commonly affects adolescents and young adults. Pain, repeated discharge, abscess formation and recurrence can interfere with work, study, sitting and social life. Several operations are available, but treatment is still difficult because faster healing may come at the cost of wound problems or later recurrence. Kshara Sutra is an Ayurvedic para-surgical method in which a medicated thread is passed through the sinus tract and changed at planned intervals. The thread keeps the tract open for drainage and produces gradual debridement while healing occurs behind it. This narrative review examines its classical basis, proposed actions, clinical use and reported outcomes, with special attention to recurrence, healing time, pain and quality of life. Published evidence specific to pilonidal sinus is limited mainly to case reports and small case series. Pilonidal sinus is a chronic inflammatory condition of the natal cleft that commonly affects adolescents and young adults. Pain, repeated discharge, abscess formation and recurrence can interfere with work, study, sitting and social life. Several operations are available, but treatment is still difficult because faster healing may come at the cost of wound problems or later recurrence. Kshara Sutra is an Ayurvedic para-surgical method in which a medicated thread is passed through the sinus tract and changed at planned intervals. The thread keeps the tract open for drainage and produces gradual debridement while healing occurs behind it. This narrative review examines its classical basis, proposed actions, clinical use and reported outcomes, with special attention to recurrence, healing time, pain and quality of life. Published evidence specific to pilonidal sinus is limited mainly to case reports and small case series.