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can anyone give me some advice regarding the use of cryotherapy in the treatment of verrucae on the lesser toes,such as the potential for nerve, vascular damage or frostbite

 

Watch the depth of the ice ball. You don't want to be freezing the joint capsule. Personaly i like to see a nice thick bit of fibrofatty padding under a lesion before i get cruel and unusual with a cryoprobe. If its over an IPJ i would'nt cryo it.

Robert

 

I am currently doing research on the use of a CryoProbe in the treatment of conditions such as plantar fasciatus,morton's neuroma etc.Does anyone have some knowledge with regards to this modalitie's effectiveness and other uses?

 

I routinely use cryosurgery for digital lesions - with care you can avoid damage to most underlying structures. I would urge particular caution however for periungual lesions near the nail matrix. Digital lesions have the added advantage insomuch as you can easily administer a local block prior to Rx - not always feasible to perform ankle blocks for plantar lesions and, of course, local infiltration is contraindicated.

MR

 

Hi.
I've been using liquid nitrogen on digital warts/verrucae (hands and feet) for over 10 years and never had any problems. The LN is applied very simply using a cotton wool bud made in the clinic. This method has proved to be clinically effective as well as cost effective. I would recommend applying it for 5-10 seconds and repeat 2 or 3 times for a digital site. This will obviously be affected by patient's pain threshold and skin thickness. Try to avoid freezing over dorsal tendons as there is some evidence to suggest that they can snap as the digit is flexed! (although I think you'd have to be rather over zealous with your technique for this to happen!).
Cryosurgery is a form of localised frostbite and should be safe if applied carefully. I would, however, never use it on a patient with poor peripheral circulation or whose tissue viability is compromised in any way.
Good luck with your treatments!

 

I see no harm in this,however,be careful on whom you use it on.

 

I had a wart on my heelI went to the doctor he used liquid nitrogen on it for 5 visits.
no difference. I felt the trauma was not great enough to elicit a big enough immune response. So I sharply debrided it then I flamed my scalpel for a bit, then I cauterized the bleeding wart. This stopped the bleeding and caused a shallow burn in the verruca. In a month it had healed completely. No wart at all. And no scar either.
Sharp debride then burn!