The primary surgical method for anal fistulas is the fistulotomy with seton placement. The duration for which the seton, made of elastic band, remains in place largely depends on the severity of the anal fistula and the amount of sphincter muscle tied. If the fistula is a simple superficial one, the seton usually falls out around seven days. In cases of high, complex anal fistulas, or those with multiple branching fistula tracts and multiple sphincters tied, the seton may take slightly longer to fall out, generally about ten days. If the seton has not fallen out after the local sphincter muscle has fully regenerated, it can be cut by a professional proctologist. However, it is important to note that postoperative care mainly involves dressing changes until the seton falls out, indicating that the wound has largely healed.