Electrocautery and Cryotherapy
Electrocautery and Cryotherapy
Electrocautery is a surgical procedure in which an electric current is used to heat a scalpel blade or wire to a high temperature. The hot blade or wire is then utilized to cauterize tissue or vessels, and even sometimes, to cut tissue (Eder et al., 2016).
Cryotherapy, on the other hand, is a pain treatment technique in which freezing temperatures are applied to localized areas in bid to inactivate irritated nerves. In dermatology, it is utilized in the treatment of abnormal skin cells (Sonnenberg, McMullen & Solbiati, 2008).
Electrocautery was first utilized in Spain in the early periods of 1900s. The discovery that high frequency alternating current in the range of 250,000 to 2,000,000 Hz could be used to incise coagulated tissue to attain homeostasis was made by Bovie in 1928 (Eder et al., 2016). In neurosurgery, the technique was made popular by Cushing after which it gained widespread utilization in other medical fields including dermatology.
Cryotherapy has a long history, dating back to ancient Egypt in 2500BCE. Starting from 1845 to 1851, an English doctor, Dr. James Arnott described the advantages of local cold application to treat a wide range of conditions including neuralgia, headaches, breast cancer and even skin cancer (Freiman & Bouganim, 2005). He also came up with a device for cold application, but it proved cumbersome to use. The development of a system for cooling gases started in 1877 with Picet of Switzerland and Cailletet of France. Further developments led to the introduction of Solidified carbon dioxide and liquid nitrogen (Freiman & Bouganim, 2005). Various cryosurgical apparatuses using different agents have been developed over the years.
Heating in electrocautery occurs through induction from an alternating current source. Electrocautery devices fall into two major categories namely unipolar and bipolar. The unipolar electrocautery devices are utilized for both surgical dissection and homeostasis. The passing of an un-dampened high frequency current through the target tissue usually sees the active electrode function as a bloodless life. It results in the disintegration of the cells at the edges of the wound (Eder et al., 2016). A thermal injury that is mild in nature emerges away from the plane of cutting, bringing about the thrombosing of blood vessels. Homeostasis can be achieved without cutting when oscillations are dampened (Griffith & Friedman, 2016). With cryotherapy, the physician places liquid nitrogen or any other cold agent on a patient’s skin. The cold temperatures deactivates irritated nerved ends (Sonnenberg, McMullen & Solbiati, 2008).
In dermatology, electrocautery is applied to a wide range of treatments including the removal of skin lesions. Skin lesions which can be removed using the technique include warts, non-cancerous moles, seborrheic keratosis and squamous cell carcinoma (Griffith & Friedman, 2016). The procedure has also proved to be effective in the removal of pyogenic granulomas and angiomas. It has also been applied in the treatment of certain types of acne (Griffith & Friedman, 2016). On the other hand, cryotherapy is often used in the treatment of cancers and precancerous lesions on the skin. Dermatologists also apply cryotherapy in the treatment of abnormal skin cells.