INSTRUCTIONS FOR CRYOSURGICAL TREATMENT WITH RECOMMENDATIONS FOR PATIENTS IN THE PRE- AND POSTOPERATIVE PERIOD

Cryosurgery is a highly effective treatment for a number of benign and malignant neoplasms of various localization and prevalence, viral and bacterial lesions of the skin and mucous membranes, trophic ulcers and keloid scars.

Liquid nitrogen, which boils at -196⁰C, is now the most widely used cryogen, effective for clinical use. Temperatures from -25⁰C to -50⁰C are reached within about 30 seconds. Benign neoplasms usually require temperatures from -20⁰C to -30⁰C. Effective removal of malignant tissue often requires temperatures from -40⁰C to -50⁰C.

Histologically, cryofreezing causes ischemia and necrosis by direct cell damage, thrombosis, and microcirculatory insufficiency. The faster the cooling, the lower the temperature reached, and the slower the thawing, the more cells die.

Other factors also influence the degree of tissue damage during cryofreezing. Different cells, tissues, and organisms have different intrinsic sensitivity to cold (melanocytes and basal cells, as well as bacteria, die easily, while fibroblasts, collagen, nerve tissue, and blood vessels, as well as viruses, are relatively immune to cold injury; this fact is one of the main cosmetic advantages of cryosurgery - minor effects on connective tissue and relatively minor damage to blood vessels and nerves).

Within 24 hours after treatment, inflammation develops, which contributes to the further destruction of the skin neoplasm under the influence of immunological mechanisms (within 1 day after surgery, tissue edema and the formation of a hemorrhagic bladder occurs in the area of the postoperative wound, which opens independently or is punctured; after 10-15 days, a hard, dry black mass forms at the site of exposure the adjacent crust; after 1-4 weeks, it will fall off and in its place will remain a delicate pink scar, which will necessarily turn pale).

Относительно немногие противопоказания для криохирургии в основном связаны с сопутствующими заболеваниями, при которых может случиться чрезмерная реакция на холод, или ожидается значительное замедление процессов заживления.

  ADVANTAGES OF THE METHOD:

Good cosmetic effect (usually absence of scars and other defects).

Good long–term results of the operation (as a rule, the minimum number of recurrences).

The anesthetic effect of the operation itself (there is no need to use additional anesthesia methods).

Hemostatic effect of the operation itself (without bleeding and pronounced hemorrhagic discharge).

Immunomodulatory effect of the operation itself (prevention of recurrence or progression of the disease, often in combination with the use of immunocorrection drugs).

Absence of symptoms of general intoxication and good tolerance of the operation itself.

  POSSIBLE UNDESIRABLE EFFECTS OF THE METHOD:

Prolonged healing of the postoperative wound (at least 10-15 days).

It is possible to develop prolonged (for several days) perifocal edema (edema of surrounding tissues).

It is possible to use repeated cryodestruction sessions in the area of the postoperative wound (mainly for malignant neoplasms).

The development of unexpressed hypopigmentation in the area of the postoperative wound (possibly its disappearance after a long time – at least several months).