Intralesional cryosurgery for the treatment of hypertrophic scars and keloids

Abstract

This chapter is aimed to describe in a comprehensive way the intralesional cryosurgery method to treat hypertrophic scars and keloid by a novel cryoneedle. This needle cryoprobe which is inserted into the core of the hypertrophic scar and keloid is connected to a canister of liquid nitrogen, which causes the cryoprobe to freeze thereby freezing the abutting scar tissue from the inside out. This chapter describes in detail the cryobiological and scientific background of the technology which includes the thermal history, cellular and structural effect, histomorphometric studies and skin pigmentation changes of treated scars. Practical clinical tips for a successful clinical application of the technology are presented which include the treatment technique, intralesional cryosurgery for auricular keloids, pain control regimen, the "tilt" maneuver and the "click" maneuver, adverse effects and contraindications. Patient satisfaction and clinical results are evaluated and presented by pre- and post-clinical photos of the treated scars. The intralesional cryosurgery technology is a new, evidence-based and fundamental adjunctive wound healing therapy which is responsible for the rejuvenation of post-cryosurgery hypertrophic scar and keloid by creating a normal wound healing environment.