Numerical modeling of the tissue freeze-thaw cycle during cutaneous cryosurgery using liquid nitrogen spray

It is common in some cryosurgical procedures to rely on freeze-thaw cycle(s) to destroy undesirable tissues. Most research in cryosurgery focuses on the freezing process and much less attention has been paid to thawing or re-warming. However, as ice melts during thawing, the extracellular solution can become locally hypotonic, driving water into cells, resulting in cell expansion and ultimately, membrane rupture. Therefore, the thermal history of the target tissue during both the freezing and thawing processes is critical for cell viability. To better understand and predict the thermal history during cryosurgery, we developed a two-dimensional numerical model to describe the complete freeze-thaw cycle during liquid nitrogen cutaneous cryosurgery. A stratified anatomical structure of human skin is considered in the model. The numerical simulation applies temperature-dependent thermal and physical properties for human skin tissue and considers the typical thermal boundary conditions for clinical practice. Parametric studies are performed to explore the influence of spray cooling, spray duration and surface heating. Results are discussed concentrating on iceball front propagation, lethal temperature isotherm evolution, tissue temperature variation and cooling rates. These results are expected to provide both quantitative and graphical support to cutaneous cryosurgery and suggest approaches to optimize current cryosurgical protocols.