A Case of Pilonidal Sinus Treated Using Kshara Sutra Made in Japan (Kanazawa Sutra I)

Abstract

We report a patient with pilonidal sinus who was treated using Kshara Sutra made in Japan (Kanazawa Sutra I) and achieved a good result. The patient was a 35-year-old man who presented with anal swelling and visited our clinic. We found three perianal abscesses at 1, 3 and 7 o'clock and a pus-discharging abscess in the sacral region. We observed the primary orifice at 3 and 7 o'clock and diagnosed low inter-sphincteric fistulas which were not associated with the abscess in the sacral region, which we diagnosed as pilonidal sinus. We initially operated on the anal fistulas using seton and Kanazawa Sutra I. Three days later we treated the pilonidal sinus using Kanazawa Sutra I. The thread was changed 8 times in 61 days. During this treatment we found two other fistulas at the midline portion and carried out the same procedures using two new Kanazawa Sutra I. The threads were changed 15 and 10 times, respectively. On the 91st day after the initial operation we found that hair was discharged from the sacral region. Epithelization was observed on the 176th day after the operation. There was no recurrence of pilonidal sinus for 7 years after the initial procedure.