Abstract
Pilonidal sinus is a suppurative condition that occurs typically in the sacro-coccygeal region between the buttocks, though it can occur in other areas like the umbilicus, axilla, between fingers and toes in barbers. The sinus may present in the form of acute abscesses or become chronic and form a discharging sinus. Surgical treatment in acute abscess is incision and drainage, but in chronic condition the commonly used surgical procedures include excision with primary closure or excision followed by reconstructive flap procedures. However, these methods are associated with a high risk of recurrence, postoperative wound infections and extended hospital stays. Effective debridement of the unhealthy epithelial tissue with adequate and meticulous wound care are the back bone of successful management of pilonidal sinus surgery. Here we present a case of Pilonidal sinus treated with Pratisaraniya Kshara (caustic alkali application). A male patient aged 24 years complaining of intermittent swelling and pus discharge for 10 days in cleft region of buttock, was diagnosed with pilonidal sinus. The track was laid open, Pratisaraniya Kshara was applied and meticulous wound care was adopted. After 1 month the wound completely healed and even after nearly 12 months of follow up there was no recurrence of abscess or sinus formation. This article highlights the uniqueness of caustic alkali therapy for the effective debridement of unhealthy fibrous tissue from the sinus track and along with meticulous wound care helped in the successful cure of the sinus, thus avoiding recurrences, repeated surgeries and longer hospitalisation to the patient.