A caustic pencil (or silver nitrate stick) is a device for applying topical

medication A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy ( pharmacotherapy) is an important part of the medical field and ...

containing

silver nitrate Silver nitrate is an inorganic compound with chemical formula . It is a versatile precursor to many other silver compounds, such as those used in photography. It is far less sensitive to light than the halides. It was once called ''lunar causti ...

and

potassium nitrate Potassium nitrate is a chemical compound with the chemical formula . This alkali metal nitrate salt is also known as Indian saltpetre (large deposits of which were historically mined in India). It is an ionic salt of potassium ions K+ and ...

, used to chemically

cauterize Cauterization (or cauterisation, or cautery) is a medical practice or technique of burning a part of a body to remove or close off a part of it. It destroys some tissue in an attempt to mitigate bleeding and damage, remove an undesired growth, or ...

skin, providing hemostasis or permanently destroying unwanted tissue such as a

wart Warts are typically small, rough, hard growths that are similar in color to the rest of the skin. They typically do not result in other symptoms, except when on the bottom of the feet, where they may be painful. While they usually occur on the ...

skin tag A skin tag, or acrochordon (pl. acrochorda), is a small benign tumor that forms primarily in areas where the skin forms creases (or rubs together), such as the neck, armpit and groin. They may also occur on the face, usually on the eyelids. ...

, aphthous ulcers, or over-production of

granulation tissue Granulation tissue is new connective tissue and microscopic blood vessels that form on the surfaces of a wound during the healing process. Granulation tissue typically grows from the base of a wound and is able to fill wounds of almost any siz ...

. They are not used as a treatment for minor skin cuts, and are not to be confused with a styptic pencil. The silver and potassium nitrates in caustic pencils is in a dried, solid form at the tip of a wooden or plastic stick. When the material is applied to a wound or lesion, the tissue moisture or blood dissolves the dried nitrate salts, which then chemically burn the tissue. It requires moisture for activation. Silver nitrate sticks are often used for minor

hemostasis In biology, hemostasis or haemostasis is a process to prevent and stop bleeding, meaning to keep blood within a damaged blood vessel (the opposite of hemostasis is hemorrhage). It is the first stage of wound healing. This involves coagulatio ...

where patients are not under general anesthesia, and where

electrocautery Cauterization (or cauterisation, or cautery) is a medical practice or technique of burning a part of a body to remove or close off a part of it. It destroys some tissue in an attempt to mitigate bleeding and damage, remove an undesired growth, or ...

would be painful and inconvenient. One common use of silver nitrate sticks is in Emergency Medicine, to control

epistaxis A nosebleed, also known as epistaxis, is bleeding from the nose. Blood can flow down into the stomach, and cause nausea and vomiting. In more severe cases, blood may come out of both nostrils. Rarely, bleeding may be so significant that low bl ...

(nosebleed). The stick is rolled on the affected mucous membrane or visible blood vessel in the nares (nostril) where the chemical cauterization stops the minor bleeding. If the bleeding is too copious, the chemical cautery may not be effective, as the flowing blood can wash away the chemical before it can react with the tissue. It can also be accidentally spread to undesirable locations where it can cause skin staining and tissue burns. This is especially important, as it is often used in the nose where accidental aerosolization can occur, splattering the clinician or other parts of the patient and causing unintentional burns. Accidental application to unintended tissue is treated with copious water irrigation, and saline solution will inactivate the chemical reaction.arzolPage

References

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