Sushruta mentioned the application of Kshara and Ksharasutra in the management of Nadivrana. Nadivrana is nothing but a tract due to not being treated the Vranashopha as per Ayurveda. The nadivrana can be correlated with the sinus tract at any part of the body tissue. Pilonidal is one kind of sinus and that can be correlated with Nadivrana. Nadivrana is said to be Kricchrasadhya (difficult to treat) and in present era the pilonidal sinus is also complicated one and difficult to treat due to its recurrence nature. In this clinical study total 17 cases of pilonidal sinus were randomly divided into two groups. 10 patients in group-A, total excision of sinus and then applied the Apamarga Kshara plota (Kshara swab) locally, in group-B rest 7 cases were treated with partial erudition of tract and applied the Ksharasutra. In both the group post operative wounds healed and cured the patients. Total excision followed by local application group was better due to less pain as compared to Ksharasutra application. In both groups no recurrence was noted till two years follow up period. Hence the study is concluded that excision and Kshara karma in pilonidal sinus is one of the potential treatment options to avoid recurrence.

Keywords: Nadivrana; Kshara; Ksharasutra; Pilonidal Sinus.