Introduction
The principles of therapeutic hypothermia have been known and applied since ancient times, and Egyptians and Greeks having been long aware of related anti-inflammatory and anaesthetic effects.
Cryotherapy involves target tissue freezing and thawing. Temperatures ranging from -20°C to -40°C are required to induce the formation of lethal intracellular ice crystals.
Working temperatures around -40°C can only be achieved with fast freezing rates (-0.5°C per second) and result in over 90% cell death.
Intracellular ice crystals promote cell dehydration and increase of electrolyte concentrations to toxic levels, directing the extracellular fluid to the inside of cells. This effect is also a response to increased cell permeability due to freeze induced denaturation of cell membrane lipoproteins.
Damage to mitochondria and other micro-organelles leads to cell death in response to oedema and cell rupture, or cryonecrosis.
Tissues such as skin, mucous membranes and granulation tissue are highly sensitive to freeze induced destruction, whereas other tissues, like fat, fibrosis, cartilage and connective tissues are less sensitive (cryosensitive and cryoresistant tissues, respectively).
The development of novel technologies and materials allowed more effective and faster tissue freezing. Cryotherapy enjoyed particular growth in dermatology, as skin lesions are exposed and easy to access. Cryotherapy is currently well-established dermatological treatment modality, with potential application in other areas.
Airway cryotherapy is applied by means of sophisticated devices and cooling agents such as nitrogen spray or catheter-based delivery of carbon dioxide, while fluorinated gases are not used.
Medical Info
DermaFreeze is recommended for cryotherapy of various benign skin and mucosal lesions. It is composed of fluorinated gases, non-toxic, odourless, non-flammable and compatible with global environmental legislation.
DermaFreeze is effective for the controlled destruction of epidermal lesions. It freezes living tissue at -30°C. A white ‘frost’ forms on the treated skin. Bigger lesions can be frozen multiple times to achieve a deeper level of treatment. The healing process is the same as that of cryosurgery with liquid nitrogen. (Tissue is destroyed at around -15°C; Dermafreeze evaporates at -30°C; liquid nitrogen at -190°C causing a lot more tissue damage than is required.)
The lesion should be cleaned with an alcohol swab. Select an applicator that when pressed down, the lesion is clearly visible. Press down on the applicator to prevent spillage when freezing. The patient should be positioned so that the applicator cone is in an upright position. Insert the tube at about a 45° angle and press/pull the trigger gently until the product covers the lesion. Keep the applicator cone in position until the bubbling (boiling) stops and you see the frost icing over the lesion. Remove the applicator. The lesion will ‘thaw’. Repeat the process if necessary. Wear safety goggles and gloves for protection.
The keratinic tissue of plantar warts should be removed mechanically before freezing it with a longer spray of DermaFreeze® to achieve a deeper level of ‘damage’. Multiple applications can be used depending on the lesion.
A dark blister will form within a day. When the blister peels off, tender skin will be exposed. Clean with saline/salt water twice a day. A product like Fix or a silicone gel can be used on the lesion at this stage.
Disinfect applicators after use – it is safe to use detergent and broad-spectrum disinfectants and the applicators can be sterilised by blue light.
Store DermaFreeze® at room temperature in a well ventilated room. Do not expose it to direct sunlight or transport it in a hot vehicle – use a cooler box for safety when in transit.
The kit consists of one 200ml Dermafreeze unit + six funnel applicators of different sizes and one applicator tube. One can is generally enough for 80-120 applications. The different funnel sizes allows for a precise margin of normal skin around the lesion and limits damage to normal skin.
Lesions suitable for treatment:
- Warts including plantar, penile, vaginal warts
- Papillomata
- Molluscum contagiosum
- Skin tags
- Keratin ‘horns’
- Pigmented lesions (actinic/solar keratosis)
- Small superficial BCC
Order
Online-orders can be placed via e-mail at orders@dermafreeze.co.za
Contact
E-mail and WhatsApp is preferred for communication during office hours.
Dr. LG Stockigt Inc.
33 Voortrekker Street
Beaufort West
6970 – RSA
T: 023 415 2663
C: 082 786 8445
e-mail: orders@dermafreeze.co.za
