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Extra info for Cutaneous Cryosurgery, Fourth Edition
The slow attenuated spray makes this method less painful and scary for young children. 13 Bent spray extension used to treat small molluscum lesions in the pubic area. The slow attenuated spray is optimal for small lesions in general. 14 Bent spray extension used to treat actinic keratosis on the face. The slow attenuated spray is more comfortable on the face and easy to control for actinic keratoses. 16 The long straight extension spray is optimal for perianal condyloma. 17). Adhesive putty may be used to create custom-fitted spray shields.
Carbon dioxide because it achieves colder temperatures more quickly, and hence treatment is faster. The nitrous oxide and carbon dioxide tanks can be refilled from a medical gas supplier or some providers have obtained the gas from other commercial sources including welding supply companies. Table 4. 1 Advantages and Disadvantages to Cryosurgery Devices Time efficiency Portability outside of primary location Initial cost Ongoing cost Status of cryogen between uses Ease of use in practice Storage considerations Liquid nitrogen Excellent Faira Moderate Low Evaporates Excellent Needs ventilation Compressed gas cryoguns Very good Poor Moderate Low No loss Good Bulky and heavy Cryoprobe Very good Excellent Moderate Low Gradual loss once activated Good Compact Cryomega Very good Excellent Low Moderate Gradual loss once activated Very good Compact Refrigerant liquids Fair Excellent Low Moderate No loss Good Compact Electrical refrigeration Very good Fair High Low No loss Good Tabletop, needs electricity to reach temperature Device Consult local rules and regulations regarding transport of small quantities of liquid nitrogen.
N Engl J Med. 1992 Oct 1;327(14): 993-7. PubMed PMID: 1298226. 2. Burkhart CG, Pchalek I, Adler M, Burkhart CN. An in vitro study comparing temperatures of over-thecounter wart preparations with liquid nitrogen. J Am Acad Dermatol 2007;57:1019–20. indd 28 15/9/14 11:07 AM Techniques Safe and effective cryosurgery does not happen by chance. It requires a proper technique, which will vary according to the type and location of the lesion, and the equipment used. Chapter 3 deals with the equipment needed for liquid nitrogen treatment and Chapter 4 reviews the different apparatus needed for successful application of compressed gas, refrigerant liquids, and electrically cooled probes.