Abstract
BackgroundCryotherapy is a safe, affordable, and effective method of treatment for cervical intraepithelial neoplasia. In some low-resource settings, environmental conditions or qualities of the refrigerant gas can lead to blockage of cryotherapy equipment, terminating treatment. A prototype of a gas conditioner to prevent operational failure was designed, built, and field tested.MethodsThe prototype conditioner device consists of an expansion chamber that filters and dries the refrigerant gas. Users in Peru and Kenya reported on their experience with the prototype conditioner. In Ghana, simulated cryotherapy procedures were used to test the effects of the prototype conditioner, as well as the commonly used "cough technique."ResultsAnecdotal reports from field use of the device were favorable. During simulated cryotherapy, the prevalence of blockage during freezing were 0% (0/25) with the device alone, 23.3% (7/30) with the cough technique alone, 5.9% (1/17) with both, and 55.2% (16/29) with neither (Pearson's Chi square = 26.6, df = 3, p < 0.001 (comparison amongst all groups)).ConclusionThis prototype design of a cryotherapy gas conditioner is a potential solution for low-resource settings that are experiencing cryotherapy device malfunction.
Highlights
Cryotherapy is a safe, affordable, and effective method of treatment for cervical intraepithelial neoplasia
Experience in developing country clinics has indicated that cryotherapy units fail due to blockage, and that preventive measures are advisable [5,6]
To the use of the conditioner devices, their experiences were that the cough technique was not a reliable method to prevent blockage
Summary
Cryotherapy is a safe, affordable, and effective method of treatment for cervical intraepithelial neoplasia. Experience in developing country clinics has indicated that cryotherapy units fail due to blockage (i.e. complete stoppage of the gas flow), and that preventive measures are advisable [5,6]. This problem arises when there is an interruption in gas flow during the procedure, and results in service disruption for several minutes while the unit thaws and the blockage clears. It can be argued that such interruptions might threaten the effectiveness of cryotherapy, since the procedure usually entails two 3-minute freezes, separated by a 5-minute interval to allow thawing of the tissue [7]. The cough technique involves briefly interrupting freezing every 15 seconds by depressing the defrost button for no more than one second and (page number not for citation purposes)
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