H&O Equipments CryoPen Series User Manual page 9

freezing cycle the tissue should be allowed
to thaw for about 30 seconds followed by
a second freeze. Note that the tissue will
freeze faster than during the first freezing
cycle. This 'freeze-thaw-freeze' technique
offers the best opportunity for success.
You will find this procedure in most
literature on cryotherapy. A follow-up
visit is recommended after 2 to 4 weeks
to confirm that all pathological tissue has
disappeared or that a follow-up treatment
is necessary.
I
Interact with your patients.
Inform patients that there will be a pain sensation similar to a
ballpoint being pushed onto the skin. Generally, little or no discomfort
is experienced during the first few seconds when you manage to
avoid treatment of healthy tissue. At a penetration rate of 1 mm per
5 seconds, the ice will reach the caudal extent of the lesion after a
given amount of time related to the depth of the lesion. From that
moment the patient will experience a pain sensation. This may be the
moment to stop treatment. You may eventually add a few seconds
more depending on the patient's comfort level and upon the clinical
evaluation of the operation . There might be a little residual stinging
for a few minutes after treatment. Occasionally, a blister might form
and persist for a few hours.
I
Reduce possible side-effects.
Although cryotherapy is a relatively low-risk procedure, some side
effects may occur as a result of the treatment. They include:
• Pigmentary changes. Both hypopigmentation (lightening of the
skin) and hyperpigmentation (darkening of the skin) may occur
after cryotherapy. Both generally last a few months, but can be
1mm 5sec
longer lasting. Avoid freezing the basal cell layer where melanocytes
2mm 10sec
(pigment producing cells) are located. Repeated short freezing
3mm 15sec
cycles of 3 to 6 seconds at two-week intervals should be used in
cases with darker skin types. This will reduce or avoid inflammation
Penetration is 1 mm per 5 in the area with melanocytes.
seconds. Consequently, treat-
ment of a 3 mm deep lesion
• Nerve damage. Though rare, damage to nerves is possible,
will take 15 seconds. A pain
particularly in areas where they lie closer to the surface of the skin,
signal from the patient will
help you to control treatment
such as the fingers, the wrist, and the area behind the ear. Reports
time.
suggest this will disappear within several months.
• Shards of frozen humidity. The innovation of CryoPen/CryoProbe
is the direct application of nitrous oxide under high pressure (55 bar).
This high pressure jet may cause minor shards of frozen humidity in
the air blown away in a circle of approximately 30cm. They will thaw
the moment they would eventually touch healthy skin. The learning
curve for utilizing the CryoPen/CryoProbe is short. Upon the clinical
evaluation of the thickness of the lesion the operator will choose
an application time from 1 to 30 seconds. With pinpoint accuracy
collateral damage resulting into pain is easy to avoid.
• Lesions on sites with coarse terminal hair. Hair follicles are easily
damaged by cryosurgery and permanent alopecia is not uncommon.
The learning curve for utilizing the CryoPen/CryoProbe is short. Upon
the clinical evaluation of the thickness of the lesion the operator
will choose an application time from 1 to 30 seconds. With pinpoint
accuracy collateral damage resulting into pain is easy to avoid.
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