Abstract

CLINICAL MANAGEMENT OF NADIVRANA (PILONIDAL SINUS) THROUGH LASER SURGERY SUPPORTED BY AYURVEDIC MEDICATION: A CASE REPORT

Sukhdeep Singh*, Sagar Negi, Savitribahen Bhabhor, Dr. Darshana Ramole

ABSTRACT

Pilonidal sinus is a chronic inflammatory disorder that commonly occurs in the natal cleft region due to the penetration of loose hair into the skin. This results in the formation of a sinus tract containing hair, debris, and infected material, which leads to symptoms such as pain, swelling, tenderness, and purulent discharge. The condition is frequently observed in young adults, particularly males, and is associated with factors such as excessive body hair, prolonged sitting, friction, and poor hygiene. If left untreated, pilonidal sinus may lead to recurrent infection, abscess formation, and repeated sinus development. In Ayurvedic literature, this condition can be correlated with Nadivrana, which refers to a chronic sinus tract with persistent discharge and inflammation. Classical Ayurvedic texts describe various surgical and para-surgical procedures for the management of Nadivrana along with internal medications that promote wound healing and reduce recurrence. Aim and Objective: The aim of this study is to evaluate the effectiveness of laser-assisted surgical management along with supportive Ayurvedic medication in the treatment of pilonidal sinus and to assess the healing pattern and clinical outcome. Materials and Methods: A 20-year-old male patient presented with complaints of swelling and pus discharge in the natal cleft region for one year, which had worsened over the last two months. Clinical examination revealed two sinus openings with a secondary swelling about 3 cm away, and probing confirmed a sinus tract of approximately 3 cm. After obtaining informed consent, the procedure was performed under local anesthesia using 2% lignocaine with adrenaline. Incision and drainage were carried out, and all hair and unhealthy granulation tissue were removed. The tract was irrigated with hydrogen peroxide and povidone iodine. Laser ablation was performed using a radial fiber. Post-operatively, daily dressing and Ayurvedic medications were administered. Results: Following the procedure, the patient experienced gradual relief from pain, swelling, and discharge. Healthy granulation tissue developed at the wound site, and progressive healing was observed during regular follow-up visits. The wound healed completely within 25 days with proper wound care and medication. Conclusion: Laser-assisted surgical management combined with Ayurvedic internal medication proved to be an effective approach for the treatment of pilonidal sinus. This method promoted faster wound healing, reduced infection, and helped in minimizing the chances of recurrence when supported with proper hygiene and preventive measures.

Keywords: Ayurvedic management, Ayurveda, Laser therapy, Nadivrana, Pilonidoplasty, Pilonidal sinus.