Abstract

Fistula in ano is one of the commonest ailments pertaining to the ano-rectal area and has frequency of occurrence. Surgical treatment of fistula in ano is associated with significant risk recurrence and high risk of impaired continence. The ksara sutra refers to a medicated thread described in the Ayurvedic text 3000 years back. This thread is prepared by repeatedly smearing special medicines. The technique of treatment involves ligating the entire fistulous tract with a caustic ligature without performing excisional therapy. infection would be a integral part of the pathogenesis of fistula in ano. The microbiology of acute anorectal sepsis is well documented but the only study on chronic anal fistula raised doubts about the relevance of infection in fistula persistence.So this study focused to assess the common microorganism in Chronic Anal fistula which were treated by using ksarasutra(medicated setone).Objective of the study was focused to on detect the common microorganism in the chronic fistula tract. The study included 30 patients, 24 men and 6 women who had underwent parasurgical treatment procedure of Kshara sutra for chronic perianal fistulae with recurrences. The pus smear was taken from the fistulous opening by sterile cotton swab and sent to the department. of microbiology, in sterile container, and where pus culture was done. Pus swab was inoculated on Nutrient Agar medium. The plated media were incubated at 37° C and examined at 48 hours after incubation. Smears from colonies that grew on the Nutrient Agar media were stained with Gram-stain. Gram-positive organisms and Gram-negative organisms were identified by conventional biochemical techniques. The incidence of fistula in ano and the origin of the predominant microorganism present in ano rectal fistula have been investigated using 100 pus samples obtained from the 30 patients.Total312 Isolates were identified. (Staphyloccusaureusand streptococusSpp were identified as skin derived organisms. Isolates of Enterococcus spp., Escherichia coli, Bacteriodesspp were considered gastro intestinal tract derived organisms. In this study the skin-derived organisms isolated from pus of (30%) appear to behave less responsible for development of fistula-in-ano; in contrast, Enterococcus spp., Escherichia coli and Bacteriodesspp(70%) grew bowel-derived organisms.

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