Role of Kshara Sutra Therapy in The Management of Nadi Varna (Pilonidal Sinus): Evidence-Based Review

Nadi Vrana, a chronic and deep-seated sinus condition characterized by pus discharge and tract formation, closely resembles modern clinical conditions like fistula-in-ano and pilonidal sinus. In Ayurveda, the treatment of such disorders is described in detail, with KST emerging as a highly effective, minimally invasive and scientifically validated technique. This review aims to explore the role of KST in managing Nadi Vrana, highlighting its principles, pharmacological basis, clinical effectiveness and integration into modern surgical practice. Several clinical studies and randomized trials have demonstrated its superiority over conventional surgical interventions in terms of recurrence rate, patient comfort and postoperative recovery. The review also discusses contributions from the Central Council for Research in Ayurvedic Sciences and the scope of integrating this traditional technique into modern evidence-based medicine. Despite challenges in standardization and global acceptance, KST remains a promising and sustainable approach for managing chronic sinus conditions like Nadi Vrana.