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14 Cards in this Set
- Front
- Back
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How does cryosurgery destroy cells
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intra and extra cellular ice formation = disruption of cell membrane, pH changes, and thermal shocl
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How to achieve maximal effect
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either longer freeze time and slow thaw time or
a series of freeze thaw cycles |
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Advantages of cryosurgery (CS)
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technical ease and portability
brief period of time for tx minimal pt prep low risk of infection no expensive supplies or anesthesia |
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CS esp usefull in what subset of pts
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elderly
high risk surgical allergic to anesthetics coagulopathies or pace makers |
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Contrindys for CS
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Lesions that need pathology for dx
located in area with comprimised circulation anything malignant previous adverse rxn to CS |
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Relative contraindys for CS
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overlying nerves
face folds or hair baring dark skinned individuals cold intolerance autoimmune disease |
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Complications of CS
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vasovagal syncope
infection hemorrhage excessive granulation tissue ring warts hypopigmentation alopecia atrophy |
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How can you prevent damage to underlying structures
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avoid over freezing
continually move skin back and forth |
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Areas where nerves are more superficial and prone to injury
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medial epicondyle of elbow
lateral aspects of digits angle of mandible |
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Pretibial are is problematic because:
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slow wound healing esp in elderly
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Pt prep CS
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explain
informed consent pt supine prepare psychologically for pain consider EMLA for peds outline lesion with surgical pen |
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Estimate depth of freeze
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1.5 times the lateral spread of visible cutaneous iceball
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Three CS methods (Read them)
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Swab method
Spray method Cryoprobe method |
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F/U CS
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Wash with soap and water 2x/d
Acetominiphen for s/p pain do not use dressing tell pt about blister erythema and edema are common crusting and separate in 10d |
