SUCCESSFUL MANAGEMENT OF FISTULA-IN-ANO BY IFTAK (INTERCEPTION OF FISTULOUS TRACT WITH APPLICATION OF KSHARASUTRA): A MINIMAL INVASIVE METHOD: A CASE REPORT

Abstract

Background: Fistula-in-ano is a chronic and often recurrent anorectal disorder characterised by persistent purulent discharge, intermittent pain, local irritation, and occasional swelling around the perianal region. The condition commonly develops following a cryptoglandular infection and significantly affects patients' quality of life due to its prolonged course and tendency for recurrence. Conventional surgical procedures such as fistulotomy, fistulectomy, advancement flap surgery, and ligation of the intersphincteric fistula tract (LIFT) are widely practised; however, these approaches may be associated with postoperative pain, delayed wound healing, recurrence, and, in some cases, varying degrees of anal sphincter injury leading to faecal incontinence. Anal sphincter damage is a danger associated with conventional surgical procedures, which frequently result in protracted wound healing. A cutting-edge, minimally invasive method called Interception of the Fistulous Tract with Application of Ksharasutra (IFTAK) is intended to maximise healing results while rigorously maintaining sphincter integrity. The Interception of the Fistulous Tract with Application of Ksharasutra (IFTAK) has emerged as an innovative sphincter-preserving technique derived from the principles of Ayurvedic parasurgical management. IFTAK involves the identification and interception of the fistulous tract at a strategic point, usually in the vicinity of the infected anal crypt or intersphincteric region, followed by the application of a medicated Ksharasutra (alkaline medicated thread). The intercepted tract allows effective drainage of septic contents and eradication of the primary source of infection while minimising tissue trauma.

Presentation of case-Presenting a Case: A 36-year-old man with recurring purulent discharge and severe perianal discomfort had no notable medical or surgical history. Chronic tobacco use and sporadic alcohol use were noteworthy aspects of the individual's past. The diagnosis of fistula-in-ano was validated by clinical examination. Following the patient's successful admission and management using the IFTAK approach, a planned three-month postoperative follow-up protocol.

Results: Pain, drainage, induration, and wound diameters all gradually decreased, according to serial follow-up evaluations. Early in the postoperative period, healthy granulation tissue formed, leading to full wound epithelialization. Over the course of the follow-up period, no recurrence, sphincter dysfunction, or other surgical problems were noted.In conclusion, the IFTAK technique offers good wound healing kinetics and a smooth postoperative recovery. It is an efficient, minimally invasive, and sphincter-preserving method for treating fistula-in-ano.