Iftak Kshara Sutra Technique for the Management of Intersphincteric Perianal Fistula-in-Ano-a Case Study

Abstract

An internal opening (primary opening) in the anal canal or rectum and an exterior opening (secondary opening) in the perianal skin combine to form a stula-in-ano, an inammatory track. Unhealthy brous tissue and granulation tissue line this tract. Intersphicteric stulas are ones that cross the internal sphincter and then have a tract to the outside of the anus leading1. The prevalence of an anal abscess-induced stula-in-ano ranged from 26% to 38%.In men,the prevalence is 12.3 cases per 100,000 population and in women, it is 5.6 cases per 100,000 population2. Fistula-in-ano is a complicated disease, its signs and symptoms which resembles bhagandara disease described in āyurvedā. ācārya suśruta mentioned this disease under a฀฀a mahāgadās which means difcult to cure. For the management of this painful disease many treatment modalities are enumerated in āyurvedā classics and k฀āra sūtra therapy is one among them which is proved to be gold standard. Though k฀āra sūtra therapy is a big revolution in the eld of stula in ano, but it has some disadvantages like it is time consuming process, severe post-procedural pain, and big scar marks. In the present case report,A 24yr old male p/t c/o pain and swelling in perianal region since three months and successfully managed with IFTAK (Interception of Fistulous tract and application of Ksharsutra) technique. which showed a greatpotential in management by minimizing the duration of treatment, mild post procedural pain and minimum scar mark.