NO.

On approval of the Montreal Protocol set into motion to ban all CFCs (Chlorofluorocarbons) production in any form and was ratified by 196 countries. The terms call for zero production of CFCs in the world by 1996. The United States stopped production in 1990.

Any use of CFCs would be considered a violation of the world wide agreement to ban production and use of Chlorofluorocarbons.

http://en.wikipedia.org/wiki/Montreal_Protocol

http://www.epa.gov/ozone/intpol/index.html

http://www.answers.com/topic/montreal-protocol

The most recent cryosurgery textbooks state that -50°C is adequate to treat most benign skin lesions. Verruca-Freeze® delivers freezing temperatures of -70°C, exceeding the minimum recommended freezing temperatures. The FDA has cleared Verruca-Freeze® for removal of 21 types of lesions including: warts, plantar warts, venereal warts (condyloma acuminatum), seborrheic and actinic keratoses, achrochordon (skin tags), molluscum contagiosum, age spots, dermatofibroma, small keloids, granuloma annulare, porokeratosis plantaris, angiomas, lentigo maligna, keratoacanthoma, lentigo discreta, chondrodermatitis, epithelial nevus, leukoplakia and pyogenic granuloma. Lesion Descriptions

A 95ml canister contains approximately 35 freezes, the 162ml canister contains approximately 65 freezes and the 236ml canister contains approximately 100 freezes. The number of lesions you can treat with a canister will depend on how large and deep the lesions are since some lesions may require a second freeze in the same office visit. For example, difficult plantar warts may require 2 or 3 freezes at the same visit while venereal warts require a very light single freeze. The number of treatments also depends on how much pressure you use to squeeze the trigger. The number of freezes per canister was determined by using the 5mm bud.

Some physicians increase the number of lesions they treat successfully by combining chemical treatment with cryosurgery. They use salicylic acid after cryo to treat difficult plantar warts and podophyllum after cryo to treat small, invisible venereal warts.

Verruca-Freeze® has two methods of application: transparent CryoCones®, available in five sizes (3mm, 5mm, 7mm, 9mm, 12mm) and CryoBuds® available in sizes small, medium and large. CryoBuds® are convenient in hard-to-reach or bony areas of the body. CryoBuds® are disposable. They can be used more than once on the same patient, but are not interchangeable between patients.

The CryoCones® are reusable and should be soaked in bactericidal solution for sterilization. CryoCones® can be autoclaved on the lowest setting if desired.

Spray time is approximately 3 to 6 seconds. When using the transparent limiting cones, accumulate approximately 1/8th inch (3mm) of cryogen into the cone. When using the CryoBud®, saturate the bud to its first drip point.

Freeze time varies depending on the size, type and depth of the lesion. Freeze time is approximately 20-30 seconds. Allow a thaw time of approximately 40 seconds. We recommend freeze-thaw-freeze on lesions greater than 5mm and plantar warts.

Through our training video, instruction manual and practice media provided with each kit, you will be able to quickly grasp how much of the cryogen to spray. Freeze and thaw times are important in order to achieve success in effectively treating lesions with Verruca-Freeze®

If you feel you have sprayed too much Verruca-Freeze®, let the cryogen spill to the floor, then remove the limiting cone, and place your hand on the lesion to stop the freeze cycle. Always protect the eyes and ears when performing cryosurgery.

Nitrous oxide can also be used for cryosurgery and is usually applied with a cryoprobe. To use nitrous oxide a physician must have a gas cylinder, a regulator, a pressure gauge, and a cryogun with assorted tips. While the gas does not evaporate like liquid nitrogen, the cost of the basic tank, without the probes can be close to $2,000 with the probes costing well over $100 each. When the tank is empty a refill can run from $50 to $178 plus delivery charges. Because the temperature is warmer than liquid nitrogen, nitrous oxide is not suitable for treating malignant cells.

Nitrous oxide is a known teratogen. In addition, because of studies done on health care professionals showing adverse health consequences, OSHA requires that all nitrous oxide systems be vented directly outside. This is not practical in many office situations.

While these methods of removing a lesion are effective, they are also time consuming and produce medical wastes and/or an unpleasant odor. With Verruca-Freeze®, the procedure takes less than one minute, there is no medical waste, no anesthetic is required, an assistant is not required, and no bandages are needed. The medical staff is not exposed to HIV or Hepatitis B viruses.

Your average cost-per-freeze is $3.00-$4.36. If you factor in your time and your staff time into the surgical equation, you can see that scalpel surgery or electrocautery cost much more but both methods are generally reimbursed at or nearly the same rate as cryosurgery.

Use the 17000 series of CPT codes for destruction of lesions. Some lesions, such as venereal warts are coded by the lesion's location. Some physicians charge $50 - $125 for an initial lesion. In some states site codes pay from $185 - $1200 depending on the location and how extensive or complicated the lesions are to treat. Reimbursement varies among insurance carriers and different areas of the country.

Contact Cryosurgery, Inc. at 800-729-1624 or info@cryosurgeryinc.com. The National Procedures Institute in Midland, Michigan teaches courses in dermatologic procedures using Verruca-Freeze®, offering classes in different U.S. cities. Contact NPI at 800-462-2492 or at The National Procedures Institute website. The AAFP and the AAPA also conduct dermatology workshops at their annual meetings.

Disinfecting CryoCones® - According to CDC guidelines, CryoCones® are classified as a non-critical medical device and may be disinfected using an EPA registered intermediate-level or lowlevel disinfectant. CaviCide® or CaviWipes™ by Metrex are highly recommended. Please follow the directions provided by the disinfectant manufacturer.

Cones can be autoclaved on the plastics setting if desired. Refer to autoclave instructions for plastics specifications. Caution: Autoclaving CryoCones® may reduce their shelf life.

Printable Version

The selection of application method is usually the physicians preference. We do recommend using our CryoBuds® for treating lesions on the head, neck, hands, thin skin, bony areas and when treating small children.

In addition to our double freeze thaw method, technique called ballooning is often used. This is often used by podiatrists treating plantar warts and veterinarians treating sarcoids on large animals. This technique involves injecting lidocaine with or without epinephrine beneath the lesion. By doing this you are separating the lesion from the blood supply which allows the ice ball to penetrate deeper.

Although some of our customers go many years without purchasing a new kit, we highly encourage the purchase of additional kits if you wish to treat patients in different exam rooms or at different offices; so you will have all the CryoCones and CryoBuds readily available. It is also our recommendation to purchase a new kit every 3 to 5 canister uses to receive additional cones and bud applicators as well as updated educational and instruction materials. The kits are priced only $60 to $75 more than the individual canisters, and are well worth the cost to update your applicators and educational materials.