The Ksharasutra was first mentioned by the Father of Surgery Sushruta in his text named SUSHRUT - SAMHITA for the treatment of sinus, fistula- in - ano, excision of small benign tumour etc. The standard kshar sutra is prepared by repeated coatings of latex of Euphorbia nerifolia, ash of Achyranthus aspera and haridra powder over a surgical linen thread. This thread is spread throughout lengthwise in hangers. Each thread on the hanger is then smeared with snuhi latex with the help of gauze piece soaked in the latex. This wet hanger is transferred in kshar sutra cabinet. This process is repeated till seven coatings of snuhi ksheer and apamarg kshar is achieved. Final three coating are completed with snuhi ksheera' and fine powder of turmeric in the same fashion. Thus twenty-one coatings over the thread are completed. Ksharsutra offers an effective, less traumatic ambulatory and safe alternative treatment for fistula in ano & sinuses with excellent success rate. Does not require hospitalization and hence saves man hours for the Doctor & Patient. Indian Council of Medical Research has published the results of Ksharsutra in Indian Journal of Medical research in June 1991, has stated that Ksharsutra is a better treatment compared to other surgical methods.
Ksara Karma is one of the most important para-surgical procedures. The word kshar means concentrated or strong salts and alkalis made mainly out of herbs. Sometimes even minerals are used to prepare a kshar. When applied locally, kshar is capable of carrying out the function of incision, excision, and scraping hence the name. Kshar karma is tridoshashamak it subdues all the three vitiated Doshas. It is versatile, because even such places that are difficult in approach by ordinary measures can be treated by Kshara Karma. It is more effective than the other modalities of treatment, because they can be administered both internally and externally. Kshara Karma is useful as the substitute of surgical instruments, because they can be used safely on the patients who are afraid of surgery.