Related Experiment Videos
Ksharsootra (medicated seton) treatment for fistula-in-ano
J D Mohite1, R S Gawai, O S Rohondia
1Department of General Surgery, Seth G S Medical College, Mumbai.
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.