Ksharsutra Treatment Ksharsutra is a popular treatment modality in India for the management of fistula-in-ano. It works by the action of excision, scraping, draining, penetrating, debridement, and sclerosing as well as healing simultaneously without a surgical excision Which is best treatment for fistula? The best and most effective way to treat Anal Fistula is surgery. Minimally Invasive Anal Fistula Treatment technique is a major breakthrough treatment option for complex fistulas. Is Ayurvedic treatment effective for fistula? Most commonly practiced surgical “lay open” technique to treat fistula-in-ano (a common anorectal pathology) has high rate of recurrence and anal incontinence. Alternatively, a nonsurgical cost efficient treatment with Ksharasutra (cotton Seton coated with Ayurvedic medicines) has minimal complications.