Surgical pearl: Readily available cryosurgery shield

Abstract

C ryosurgery is a very common procedure in dermatology, used to treat benign as well as precancerous and cancerous lesions. Often these lesions are located near sensitive structures. Protection of these structures from stray liquid nitrogen is often necessary. An effective cryosurgery shield can be made by simply folding a piece of paper, such as a prescription sheet, twice. One of the outer free edges so created can be folded over about 1 cm to form a gutter that directs the liquid nitrogen away from the hand of the cryosurgeon. The shield is held in the non-dominant hand by the posterior, straight free edges of the shield. The single creased edge formed at the base is placed against the patient’s skin in front of the delicate structure being protected. Such a shield can also be useful in elevating acrochordons, and a V-fold of the shield around the skin tag restricts freezing to the tag, further protecting surrounding skin (Fig 1). For added comfort a glove can be worn when holding the shield if numerous lesions are to be treated. The paper shield is thrown away after use, and a new one made for each patient.