Abstract

Dr. Manoj D. C.*, Dr. Shailaja S. V.

ABSTRACT

Background: Pilonidal sinus disease (PSD) is a common debilitating condition predominantly affecting young males. While conventional surgery remains the mainstay, recurrence and wound complications persist. Ayurveda describes a minimally invasive parasurgical technique—Ksharasutra—that has shown promising outcomes. This study aims to conduct a meta-analysis comparing Ayurvedic and conventional treatments for PSD. Methods: Seven peer-reviewed articles (3 Ayurvedic case series, 1 case report, 2 clinical trials on conventional surgeries, and 1 large-scale meta-analysis) were analyzed. Key parameters assessed included healing time, recurrence rate, complications, and patient comfort. Results: Ayurvedic Ksharasutra treatment demonstrated a mean healing time of 4–5 weeks with no recurrence reported in follow-ups ranging from 3 months to 20.4 months. Surgical interventions (n=89,583 in pooled data) showed varying recurrence: Karydakis/Bascom procedures (0.2% at 12 months) outperformed midline closures (up to 67.9% at 240 months). Healing time post-excision averaged 65–68 days. Hydrocolloid dressings improved comfort but didn’t reduce healing time. Conclusion: Ksharasutra therapy offers an effective, low-cost, minimally invasive treatment for uncomplicated PSD with negligible recurrence and faster healing. While modern flap surgeries remain superior in complex cases, Ksharasutra should be considered a first-line approach in select patients.