Return to Skip Menu Publications and Educational Resources Return to Skip Menu WE ACCEPT PURCHASE ORDERS purchase orders from hospitals, research facilities, government institutions, Cryosurgery  » CRY AC Brymill is the world’s leading manufacturer of handheld, liquid nitrogen (LN2) cryosurgical and cryospray devices used to treat a wide range of common skin lesions, including Verruca (warts), Actinic Keratoses, Seborrheic Keratoses, Molluscum, Papilloma (skin tags), Lentigines (age spots), Condyloma (genital warts), and Basal Cell Carcinoma (skin cancer). The #1 choice of dermatologists, Brymill offers unsurpassed safety, versatility, and control for precise and effective cryosurgery. CRY-AC® and CRY-AC®-3 units have a 3-year warranty covering parts and labor 6 spray tips with varying sized apertures (.04 - .016 inches), 20g Straight Spray and a 20 gauge bent spray are included with CRY-AC® and CRY-AC®-3 units for more accurate, controlled treatment of lesions of different sizes and types

greater capacity & longer holding time 20 to 24 hours 10 to 12 hours Family Practice Package includes Choice of either the 10 or 16 oz CRY-AC hand-held liquid nitrogen deliveryac unit running but no fan Withdrawl tube (Model 503)heat pump unit 43 20 liter storage dewar (Model 501-20SC)home central ac diagram Withdrawl tube (Model 502) 20 liter storage dewar (Model 501-20) The Cry-Ac®Tracker® Cam is a device that measures the temperature of the skin when spraying Liquid Nitrogen via the Cry-Ac® delivery system to the selected skin lesion using the latest Infrared Sensoring technology. The operator can set the Cry-Ac®Tracker® Cam to indicate when a predetermined freeze temperature has been achieved at the lesion.

For More Precise & Effective Cryosurgery Consistently achieve desired skin temperature & freeze time. More accurately perform cryosurgery. Know how long to spray & when to stop. Quickly train others to reliably do cryosurgery. Achieve optimum results for patients. Infrared light sensor continuously & safely monitors skin temperature at Color-coded lights shine on lesion to indicate how fast skin temperature is decreasing and when desired skin temperature is reached. With our revolutionary new infrared sensors and built-in camera, you can: Get a clear, precise view of the lesion area Program applications by skin temperature and freeze time for better control Cry-Ac®Tracker® Camliquid nitrogen delivery system 10 oz. (300ml)Includes (2) C & (1) B Aperature 10 oz. Cry-Ac®Tracker® Camin. x 20g Straight Spray Needle Tips All contents Copyright 2016 by SouthPointe Surgical Supply, Inc.Any information on this website may not be copied, reproduced or

distributed without prior written permission. Basal cell carcinoma CME Benign keratinocytic and adnexal lesions Dermal and subcutaneous tumours Epidemiology of non-melanoma skin cancer Introduction to skin surgery Topical treatment of photodamage Originally developed for the University of Auckland Goodfellow Unit in 2007. The course and several interactive quizzes are available on CD – from the Goodfellow Unit. You may download the order form for the CD-ROM (PDF file).Author: Hon A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand, 2008.  Images have been sourced from the following:Hon Assoc Prof Amanda Oakley The Department of Dermatology, Waikato Hospital MoleMap New Zealand (with permission) Describe the use of physical therapies in the treatment of skin lesions including cryotherapy, radiotherapy, photodynamic therapy, laser and pulsed light therapy. Physical therapy of skin diseases refers to treatment that employs heat, cold, ionising and non-ionising radiation.

Cryotherapy is used to reduce or remove superficial skin lesions, including: Using a special technique, it may also be used to treat superficial non-melanoma skin cancers. Cryotherapy should not be used if there is any doubt about the pathology of the lesion, especially if melanoma is within the differential diagnosis. Although well tolerated by adults, treatment stings and is inappropriate in young children unless unavoidable. Liquid nitrogen (boiling point –196C) is the most useful cryogen. It can be delivered to medical practices at low cost (e.g. $2/litre) as required. It should be stored in an purpose-designed Dewar. The most popular are 20-litre vacuum tanks that can hold unused liquid nitrogen for up to several months. The tanks may last 10 or 20 years but do eventually suddenly or slowly lose their vacuum. The nitrogen may be carefully poured into a smaller container or a special withdrawal tube may be used. It is dangerous to store nitrogen in a glass thermos as this may explode destructively if inadvertently sealed.

A steel flask is necessary and there must always be a release valve. Nitrogen can be applied to the lesion using a loose hand-made cotton-tip swab, but it may be difficult to be accurate. The swab should not be re-dipped into the nitrogen flask as viral particles may be transmitted. Instead, use a new swab or pour nitrogen into an insulated small container that is single-use or sterilised between patients. A hand-held spray unit is much more convenient and accurate, providing a constant fine jet of liquid nitrogen. Different size spray nozzles, adapters and probes are available for different sized lesions in different sites. The tip of a spray nozzle should be held about 1 cm away from the skin surface and perpendicular to it. The lever is gently and repetitively squeezed to maintain a constant area of freeze up to 1 cm in diameter. The diameter of the freeze may be confined to the lesion (seborrhoeic keratoses, actinic keratoses, molluscum contagiosum) or include 1 mm of surrounding normal skin (viral warts).

Benign superficial skin lesions may resolve with freeze/thaw times of 5 to 30 seconds depending on the depth of the lesion. Effective cryotherapy of malignant lesions requires training and experience, and a wider margin (most recurrences after cryotherapy arise on the periphery of a lesion because the freeze failed to reach sufficiently low temperature). Longer freezes cause deeper damage and greater morbidity. Tissue injury depends on the rate of cooling, minimal temperature reached and freeze/thaw time. A temperature of –30 to -50C ensures destruction of malignant cells, particularly if the freeze/thaw cycle is repeated. Short term blistering, exudation, , ulceration Long term adnexal damage, anaesthesia, and (rarely) scarring Erythema and swelling an Haemorrhagic blister at 24 hours Oedema and wound infection Radiotherapy is the use of ionising radiation to treat skin diseases. Although frequently used in the 1960's and 70's to treat benign and malignant skin conditions, radiotherapy is rarely recommended nowadays because of the risk of the development of further malignancies and poor long term cosmetic results.

Current indications for radiotherapy of skin disease include: Some basal cell and cell cancers in the elderly Rarely, intractable localised inflammatory skin disease. Malignant skin lesions are treated with multiple fractions of superficial X-rays delivered over two or three weeks. Treated areas become inflamed and may ulcerate before healing. Eventual scars tend to have a waxy atrophic appearance with telangiectasia and a tendency to break down with minor injury. Photodynamic therapy (PDT) involves an oxygen-dependent phototoxic reaction and is used to treat superficial forms of non-melanoma skin cancer and other skin conditions. The photosensitiser (usually a porphyrin) can be given intravenously or can be applied to the target lesion topically (most often methyl aminolevulinate). It is selectively localised in the target tissue and is later illuminated with visible light (often 611 nm with a diode source), resulting in photodamage and subsequent cell death. There is minimal damage to surrounding normal tissue hence side effects are limited to the target area.

As a rule, cosmetic results are good or excellent. The day following PDT One month following PDT Lasers were first used in New Zealand in the 1980's to treat vascular birthmarks (port wine stains). The word 'laser' is an acronym for Light Amplification by Stimulated Emission of Radiation. Current therapeutic lasers remain expensive and hence are restricted to a small number of dermatology and cosmetic medicine practices in major centres. The important properties of laser light are: Continuous wave or pulsed (to reduce transmission of heat to surrounding tissues) Different models are now commonly used to treat the following type of skin lesion: Red lesions: yellow light to remove facial and vascular birthmarks; Brown lesions: green or red light to remove freckles and pigmentation; Tattoos: various wavelengths are required to remove different colours; Epidermal lesions (skin tags, viral warts, seborrhoeic keratoses): a bloodless knife;vaporisation by carbon dioxide or erbium lasers;

Epilation: removal and permanent reduction of dark hairs using various wavelengths. After copper bromide laser Advantages of laser treatment include: More precise hence less risk of damage to other tissues or scarring; For some indications, it is more effective than other known treatments; It may be quicker or more convenient than other treatments. Microwaves and non-coherent broadband flash lamps are also available for hair removal. A flash lamp may also be useful to treat vascular lesions and for non-ablative rejuvenation of the skin (dermal remodelling). Radiofrequency devices may also tighten lax tissues to a modest degree. Interested practitioners should undertake a laser safety course and carefully evaluate the range of devices available. A viable business depends on the local market, capital and running costs of equipment and staff and efficacy. Undertake practical training in cryotherapy (ask your local dermatologist) or purchase a training video / CD-ROM.