Cauterize

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The medical practice or technique of cauterization is the burn (injury)|burning of part of a body to remove or close off a part of it in a process called cautery , which destroys some tissue, in an attempt to mitigate damage, remove an undesired growth, or minimize other potential medical harmful possibilities such as infections, when antibiotics are not available. The practice was once widespread for treatment of wounds. Its utility before the advent of antibiotics was effective on several levels:

useful in stopping severe blood-loss and preventing exsanguination

to close amputation s

Cautery was historically believed to prevent infection, but current research shows that cautery actually increases the risk for infection by causing more tissue damage and providing a more hospitable environment for bacterial growth.

Actual cautery is a term referring to the white-hot iron—a metal generally heated only up to a dull red glow—that is applied to produce blisters , to stop bleeding of a blood vessel , and other similar purposes., page 16.

The main forms of cauterization used today in the first world are electrocautery and chemical cautery —where both are, for example, prevalent in the removal of unsightly wart s. Cautery can also mean the Human branding|branding of a human , either recreational or forced.

History

Cauterization was used to stop heavy bleeding, especially during amputation s. The procedure was simple: a piece of metal was heated over fire and applied to the wound. This would cause tissues and blood to heat rapidly to extreme temperatures in turn causing coagulation of the blood thus controlling the bleeding, at the cost of extensive tissue damage.

Cautery is described in the Hippocratic Corpus . The cautery was employed for almost every possible purpose in ancient times: as a ‘ counter-irritant ’, as a haemostatic , as a bloodless knife, as a means of destroying tumour s, etc. Later, special medical instruments called cauters were used to cauterize artery|arteries . The technique of Ligature (medicine)|ligature of the arteries as an alternative to cauterization was later improved and used more effectively by Ambroise Paré .

Electrocautery

Electrocauterization is the process of destroying tissue using heat conduction from a metal probe heated by electric current. The procedure is used to stop bleeding from small vessels (larger vessels being Ligature (medicine)|ligated ) or for cutting through soft tissue. Unlike electrocautery, electrosurgery is based on generation of heat inside tissue, using electric current passing through the tissue itself, and when used to stop bleeding, is technically referred to as electrocoagulation. Electrosurgery techniques are used in the treatment of skin cancer s via electrodesiccation and curettage .

Electrocauterization is preferable to chemical cauterization because chemicals can leach into neighbouring tissue and cauterize outside of the intended boundaries.See Mr. R. McElroy for details of various operations and the unintended effects of chemical cauterization

Ultrasound|Ultrasonic coagulation and ablation systems are also available.

Chemical cautery

Many chemical reactions can destroy tissue and some are used routinely in medicine, most commonly for the removal of small skin lesions (i.e. warts or necrotized tissue) or hemostasis . The disadvantages are that chemicals can leach into areas where cauterization was not intended. For this reason, laser and electrical methods are preferable, where practical. Some cauterizing agents are:

Silver nitrate : Active ingredient of the lunar caustic , a stick that traditionally looks like a large match-stick. It is dipped into water and pressed onto the lesion to be cauterized for a few moments.

Trichloroacetic acid

Cantharidin : An extract of the blister beetle that causes epidermal necrosis and blistering; used to treat warts.

Nasal cauterization

If a person has been having frequent nose bleed s, it is most likely caused by an exposed blood vessel in their nose. Even if the nose is not bleeding at the time, it is cauterized to prevent future bleeding. The different methods of cauterization include burning the affected area with acid, hot metal or lasers. Such a procedure is naturally quite painful. Sometimes liquid nitrogen is used as a less painful alternative, though it is less effective. In the few countries that permit the use of cocaine for medicinal purposes, it is Cocaine#Cocaine as a local anesthetic|occasionally used topically to make this procedure less uncomfortable; cocaine being the only local anesthetic which also produces vasoconstriction , making it ideal for controlling nosebleeds. More modern treatment uses silver nitrate , a local anesthetic is applied and the procedure is generally painless. The nose may run for up to a week after the procedure.

Amputational cauterization

In some countries that practice hudud (or hudood ) as the legal penal code, cauterization may be used to prevent death due to severe loss of blood.

Infant circumcision

Cauterization has been used for the circumcision of infants in the United States and Canada . The College of Physicians and Surgeons of Manitoba advise against its use in neonatal circumcision.College of Physicians and Surgeons of Manitoba. Neonatal Circumcision. Winnipeg: College of Physicians and Surgeons of Manitoba, 1997. This method of circumcision resulted in several infants losing their penises , with at least genital modification and mutilation|seven male children being reassigned as female ."Family Is Awarded $850,000 For Circumcision Accident" New York Times|The New York Times , New York, USA, Published November 2, 1975"David Reimer, 38, Subject of the John/Joan Case" New York Times|The New York Times , New York, USA, Published May 12, 2004Charles Seabrook. $22.8 million in botched circumcision. Atlanta Constitution, Tuesday, March 12, 1991.Schmidt, William E New York Times|The New York Times , Published October 8, 1985Vincent Lupo. Family gets $2.75 million in wrongful surgery suit. Lake Charles American Press, Wednesday, May 28, 1986.Gearhart JP, Rock JA. Total ablation of the penis after circumcision with electrocautery: a method of management and long-term followup. J Urol 1989;142(3):799-801.

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