# Medicated Alkaline Thread

> Medicated Alkaline Thread (Sanskrit: Kshara Sutra) is an instrument used in kshara sutra and para-surgical instruments. A specially prepared surgical thread coated with three layers: latex of Snuhi (Euphorbia neriifolia), Apamarga Kshara (Achyranthes aspera alkali), and Haridra (turmeric) powder. Applied repeatedly (21 coatings) to create a medicated thread used for gradual cutting, drainage, and healing of fistulous tracts.

## Key facts

- **Sanskrit name:** Kshara Sutra
- **Ayurvedic category:** Kshara Sutra and Para-Surgical Instruments

A specially prepared surgical thread coated with three layers: latex of Snuhi (Euphorbia neriifolia), [Apamarga](/herb/apamarga/) Kshara (Achyranthes aspera alkali), and [Haridra](/herb/haridra/) ([turmeric](/herb/turmeric/)) powder. Applied repeatedly (21 coatings) to create a medicated thread used for gradual cutting, drainage, and healing of fistulous tracts.

## Where is it described in the classical texts?

Sushruta Samhita Chikitsasthana Chapter 17 (Bhagandarachikitsitam) describes Kshara Sutra for Bhagandara (fistula-in-ano). Further developed by Dhanwantari and described in Chakradatta, Rasaratna Samuchaya.

## How is it used traditionally?

Fistula-in-ano (Bhagandara) - primary indication. Also used for hemorrhoids (Arsha), pilonidal sinus, and chronic non-healing sinuses. ICMR-validated technique. WHO recognized as a minimally invasive alternative to fistulotomy.

## Traditional materials

- Barbour's linen thread (No. 20)
- Snuhi Kshira (Euphorbia neriifolia latex)
- [Apamarga](/herb/apamarga/) Kshara (Achyranthes aspera alkali)
- [Haridra](/herb/haridra/) Churna (Curcuma longa powder)

## Modern variants

- Standardized Kshara Sutra prepared under GMP conditions
- Modified Kshara Sutra with different alkaline agents
- Kshara Sutra with antibacterial coatings

## Regulatory status

- **India Cdsco:** Kshara Sutra is recognized as a validated Ayurvedic surgical procedure. ICMR-validated. Taught in BAMS curriculum. Regulated under AYUSH surgical practice guidelines.
- **Us Fda:** Not FDA-cleared. Would require regulatory pathway determination (likely Class II or III) if marketed as a medical device in the US.
- **Eu Mdr:** Not CE-marked. Would require classification under EU MDR (likely Class III due to implantable/invasive nature).

---

Canonical version of this page: https://nighantu.ageayurveda.com/device/medicated-alkaline-thread/

Published by Age Ayurveda in the Nighantu. Educational reference only, not medical advice.
Incorporates material from the Amidha Ayurveda Herb Database under CC BY 4.0.