Cautery Looked through the Prisms of Shapes, Types and Methods: A Critical Appraisal

Abstract

Background: Traditional cautery (in Arabic Kai) is an ancient practice and used in a variety of diseases with variable efficacy around the world. Objective: This review aimed to describe critically and synthesise the literature on shapes, types and methods of cautery therapy. Methods: Electronic searches of four databases (PubMed, MEDLINE, Google Scholar, and OvidSP) using the Boolean operators and keywords were conducted, and some pertinent articles and abstracts (N=10256) were retrieved for extensive appraisal by two independent reviewers. Finally, 90 articles were included in this paper. Results: Cautery is described in the literature having multiple shapes, types, application marks, precautions and methods and efficacy supported by single case reports and case series with evidence level 4 & 5. Traditional cautery with specific shape and type is used in particular diseases together with a precise procedure, but the underlying mechanism of actions and effects are not well elucidated. Conclusion: Cautery a recognised complementary and integrative therapy having different instrument shapes, types, application marks, methods and procedures and anatomical sites is used in many recommended diseases. Cautery is a safe therapy when used cautiously by an expert trained complementary and alternative medicine (CAM) practitioners and trained health professionals around the world. Unlike modern cautery, traditional cautery is mostly recommended as the last choice in the management of difficult-to-treat medico-surgical conditions, but this rule is not followed by health seekers characterised by low education, rural background, parental influence and strong religious convictions. This study calls for continuous cautery training programs directed towards CAM practitioners and conducting rigour basic research and randomised clinical trials for elucidating the underlying mechanism of actions and effects and effectiveness of cautery therapy in various indicated diseases around the world.