ADR KSHARSUTRA KIT: A BREAKTHROUGH IN THE STANDARDIZATION OF KSHARSUTRA

‘Ksharsutra’ can be defined as an Ayurvedic medicated thread coated with herbal alkaline drugs. ‘Ksharasutra therapy’ has been described as a treatment of choice for the treatment of fistula-in-ano due to low recurrence rate. However, Ksharsutra procedure is not yet globally accepted basically due to lack of standardization and poor acceptability by modern surgeons due to lack of training and fear of complications. Standardization of ‘Ksharsutra’ requires standardization in preparation process and quality standards including its packaging, storage, labeling and developing scientific parameters for maintaining its uniform coating, pH, microbial check etc. To overcome all these limitations, ‘ADR- Ksharsutra Kit’ which is a disposable, non traumatic ‘Ksharsutra Carrier cum Application device’ made up of High Density Poly Ethelene was invented by me. The Ksharsutra prepared as per ICMR guidelines after UV treatment, is embedded in the instrument and is kept in airtight silver foil sachet and sealed. The method of ‘ADR-Ksharsutra’ application is simple and time conserving. The tip of the ‘ADR-Ksharsutra Carrier cum Application device’ is introduced in the external opening and allowed to follow the track up to the internal opening situated in the anal canal. Once the tip comes out through the internal opening, cap is removed and the Ksharsutra is held and then instrument is withdrawn from outside opening. By doing this, the embedded Ksharsutra is automatically placed in the fistula track whose two ends are tied together. ‘ADR-Ksharsutra’ has truly made the entire procedure very smooth. No probe is required in the procedure and Ksharsutra kept in the instrument remains sterile as well. Hence, this ‘Ksharsutra carrier cum application device’ will be helpful in Globalization of Ksharsutra technique for fistula ablation.