Nadivrana (Pilonidal Sinus) treated with Ayurved medicament - Clinical images
Pilonidal sinus (PNS is also termed as jeep disease and found in hairy young male patients and usually it recur after total excision and any surgical intervention. PNS can be correlated with Nadivrana as per Ayurveda classic. Management of Nadivrana is vividly described by Sushruta along with surgical excision of the total tract [Su.Chi-17/18]. The patient of recurrent PNS treated with total excision under local xylocain 2% along with removal of all three branches i.e. wide excision. After excision the big wound (8cm length x 5cm width) was treated with local application of teekshna Apamarga Kshara (Kshara/alkali of strong potency) and Thumari oil (Securinega leucopyrus) along with internal Ayurved medicine (Triphala Guggulu 1 gm three times a day).
The Apamarga Kshara helped to remove all the dead tissue or debris from base of sinus and having shodhan and ropern properties.  Thumari oil (Securinega leucopyrus) is proved for its healing potential in non-healing wounds.  Patient was completely cured within 60 days. The follow up was done to see recurrence every year and there was no recurrence. The case was treated in month of October 2016 and till date i.e. September 2019 patient is absolutely free from any symptoms with mild post-operative scar.