Cauterization is a medical term describing the burning of the body to remove or close a part of it. The main forms of cauterization used today are electrocautery and chemical cautery. Cautery can also mean the branding of a human, either recreational or forced. Accidental burns can be considered cauterization as well.

History of Electrosurgery
Cauterization was used to stop heavy bleeding, especially during amputations. 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. Later, special medical instruments called cauters were used to cauterize arteries. Abu al-Qasim al-Zahrawi also introduced the technique of ligature of the arteries as an alternative to cauterization. This method was later improved and used more effectively by Ambroise Paré.

Electrocautery
Electrocauterization (also called electric surgery or electrosurgery) is the process of destroying tissue with electricity and is widely used in modern surgery. The procedure is frequently used to stop bleeding of small vessels (larger vessels being ligated) or for cutting through soft tissue i.e. abdominal fat in a laparotomy or breast tissue in a mastectomy. Electrocauterization is preferable to chemical cauterization because chemicals can leach into neighboring flesh and cauterize outside of the intended boundaries.

Electrosurgical Generator
The Electrosurgical generator (ESG), more commonly referred to as an electrosurgical unit (ESU) or simply as a generator, powers an electrosurgical system with electricity at an appropriate voltage, frequency and waveform for cutting or for coagulation, as required.

Frequency for Electrosurgery Procedure
To prevent electric shock, an alternating frequency that is higher than power from standard wall outlets is used. Normal AC "house-current" runs at 50–60 Hz and is quite lethal, since at every alteration nerves and muscles get stimulated, causing violent cramps 50–60 times a second. However, nerve and muscle stimulation cease at 100 kHz due to alterations being too fast for the cells to pick up, permitting that Electrosurgery may be performed safely at these "radio" frequencies above 100 kHz.

Description of Cutting and coagulation
Different cauterizing effects can be achieved by changing the voltage of the current as well as the pattern of electric pulses. When lower voltage is used with a continuous alternating current (AC), heat is produced very fast and tissue is completely vaporized at the tip of the probe. The effect is dubbed "cutting". When a higher voltage current is used in a pulsed manner, heat is produced more slowly, tissue damage is more widespread (a few mm from the probe) and blood coagulates, and in many electrosurgery instruments this is called "coagulation" mode). This is also used for ablation. Usually a "blend" setting is available as well.

Difference Between Bipolar and Monopolar Cauterization
Two kinds of electrocautery are used, monopolar and bipolar (aka. monothermy and diathermy, respectively). Both involve high frequency alternating current and a pair of electrodes, one called active and the other returning. The difference lies in the placement of these electrodes:

*Monopolar: Current is passed from the probe (active electrode) where cauterization occurs and the patients body serves as a ground. A grounding pad (returning electrode) is placed on the persons body, usually the thigh, and it carries the current back to the machine. Careful application of the return electrode is necessary as extensive burns can occur undetected if the electrode is not correctly positioned.

*Bipolar: The active and receiving electrodes are both placed at the site of cauterization. The probe is usually in the shape of a forceps with each tine forming one electrode, cauterizing only the tissue between the electrodes.

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