What is Cauterization and Is it Used to Treat Anal Fissures?

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Cauterization is a medical practice that traces its roots back to the Renaissance period when there was no sufficient equipment to stop bleeding, close wounds and prevent infections. This discovery of Belgian scientist Andreas Vesalius, the father of the study of anatomy, was widely used to close a wound after amputation. The procedure includes heating a piece of metal and then placing it on the wound. As the metal is placed on the wound, the tissues would coagulate due to extreme heat.

In 16th century, French surgeon Ambroise Paré built on the foundation of Vesalius to contribute knowledge in surgery. Paré opted to sew the wound shut instead of burning it to close. His procedure to close a wound was deemed merciful than that of Vesalius, but the latter’s discovery is still practiced in the 21st century.

Scientific breakthroughs, however, altered the procedure, making it faster and less painful. Instead of heating a metal over fire, this new method makes use of electricity to heat tissues. A grounding pad should be placed on a person’s lap while undergoing electro-cauterization to prevent the harmful effects of high-frequency electricity.

The modern cauterization (electro-cauterization) has two methods: unipolar and bipolar.
When treating patients using unipolar cauterization, the doctors would use a single pencil-like electrode to treat the area. The difference between the two methods will be further discussed in this article.

Unipolar cauterization primarily uses a small, single tipped electrocauter to zap a large area of tissue such as the buttocks or other areas with the same comparable size. Heat varies from a multitude of factors such as area with which contact is made, power setting or the frequency that the current is applied, the duration of the application, and its waveform. If applied constantly, the waveform generates more heat. If used in coagulation mode, the frequency that needs to be generated tends to be higher to be able to cut through tissue.

Bipolar cauterization makes use of the tip of a forceps like tool to pass its current. An added advantage of favoring bipolar compared to unipolar cauterization is that it does not disturb the body’s other electrical rhythm. Compared to unipolar cauterization, the risk of suffering from lateral thermal burns from bipolar cauterization is significantly lower. The main concern is the smoke produced from surgical electro-cautery, which is believed to be toxic. It is believed that it contains chemicals that when inhaled may harm both the patient and the medical staff.

A less popular form of cauterization is chemical cauterization, having a higher chance of chemicals bypassing the intended boundaries and cauterizing neighboring tissue. Chemical cauterization primarily destroys the tissue and is routinely used in medicine. Often used in removing small skin lesions such as warts and necrotized tissues. Chemicals commonly used are silver nitrate, trichloroacetic acid, and extract from blister beetle called cantharidin.

Cauterization is used to treat anal fissures by using electrocautery to close the wound without cutting the muscles. Prior to the procedure, the doctor cleans the area, and finish the treatment by injecting steroids into the wound.

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