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14 Cards in this Set

  • Front
  • Back
How does cryosurgery destroy cells
intra and extra cellular ice formation = disruption of cell membrane, pH changes, and thermal shocl
How to achieve maximal effect
either longer freeze time and slow thaw time or
a series of freeze thaw cycles
Advantages of cryosurgery (CS)
technical ease and portability
brief period of time for tx
minimal pt prep
low risk of infection
no expensive supplies or anesthesia
CS esp usefull in what subset of pts
high risk surgical
allergic to anesthetics
coagulopathies or pace makers
Contrindys for CS
Lesions that need pathology for dx
located in area with comprimised circulation
anything malignant
previous adverse rxn to CS
Relative contraindys for CS
overlying nerves
face folds or hair baring
dark skinned individuals
cold intolerance
autoimmune disease
Complications of CS
vasovagal syncope
excessive granulation tissue
ring warts
How can you prevent damage to underlying structures
avoid over freezing
continually move skin back and forth
Areas where nerves are more superficial and prone to injury
medial epicondyle of elbow
lateral aspects of digits
angle of mandible
Pretibial are is problematic because:
slow wound healing esp in elderly
Pt prep CS
informed consent
pt supine
prepare psychologically for pain
consider EMLA for peds
outline lesion with surgical pen
Estimate depth of freeze
1.5 times the lateral spread of visible cutaneous iceball
Three CS methods (Read them)
Swab method
Spray method
Cryoprobe method
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