Reference Manual - IARC Screening Group

Treatment and Followupcancer treatment (Figure 7-4). Clear plastic protective sleeves, whichprevent the shaft of the cryotip from contacting and freezing vaginaltissue, are provided with some cryotherapy units.Figure 7-4. Cryotip and Protective SleeveSuppliesThe supplies needed to perform cryotherapy are the same as thoseneeded for VIA:• Cotton swabs• New examination gloves or high-level disinfected surgical gloves• New wooden spatula• Dilute (3–5%) acetic acid (white vinegar is acceptable)• 0.5% chlorine solution for decontaminating instruments and gloves• A record formCotton swabs are used to wipe the cervix and remove mucus ordischarge before performing cryotherapy. These swabs should begenerously covered with clean cotton so that they will not scratch orinjure the cervix. The cotton swabs do not have to be sterile.Examination gloves should be new. (If surgical gloves are being reused,they should be high-level disinfected after each use. Sterile gloves are notnecessary.) Use a new pair of gloves for every patient.A wooden spatula is used to protect the lateral walls of the vagina fromthe cryotip, particularly in patients who have very lax vaginal walls. Usea new wooden spatula for each patient.Chlorine solution (0.5%) is used to decontaminate the speculum andsurgical gloves after each use. After decontamination, the speculum,instrument tray or container, and surgical gloves should be washedthoroughly with soap and water, thoroughly rinsed and then high-leveldisinfected or sterilized. (See Appendix C for detailed information onhow to prepare the chlorine solution.)7-12 Cervical Cancer Prevention Guidelines for Low-Resource Settings