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I have been using Liquified phenol for nail avulsions. I have recently come across Phenol Crystals being sold. How do you use them? I presume they are dissolved in water? how do you determine accurately a solution approx equal to 89% liquefied phenol from the crystals?

Seeing as no-one else seemed to know how to use phenol crystals, i have given up on that idea and ordered some EZ swabs!
Much simpler!
:)

I use phenol crystals for phenolisation procedures and have had no problems. All you have to do do is raise the temperature of the glass container and the crustals will liquify. Keep the temperature above 30°C or they will recrystalize. The recommended time of phenolisation is 45 sec, diluted with 70 - 90% OH and rephenolise fro another 45 sec and copiously flush out the sulcus with OH once again.

Regards
Maurizio Mazzoncini
BSc Pod (UK)

Other use for the crystals is as a wart treament yvonnespod

how are they used for wart treatment, can you please give the technique and length of time you recommend the crystal is left in contact with the skin?

Does anyone know where you can buy phenol or liquified phenol from in the uk?

I don't think one should use phenol crystals directly in contact with the verruca. One can use a 80% saturated solution of phenol on the wart for 60 seconds repeated twice. The phenol has an anaesthetic effect and therefore very little pain is felt. remember to be selective with regards patient health i.e. circulation, metabolic disease, age, location and number of lesions treated in one sitting, before using thsi type of therapy. Dress the area with an antiseptic to prevent infection if there is a localised necrosis of tissue, often after 72 hrs the patient will present him/herself with a haematoma of blister which can be drained and dressed daily.

Maurizio Mazzoncini

"All you have to do do is raise the temperature of the glass container and the crustals will liquify. Keep the temperature above 30°C or they will recrystalize."

mazzoncini - what are the implications for the person who is heating the phenol crystals?

__________________
If you are on the rollercoaster, open your eyes and enjoy the ride.

No implications whatsoever, the crystals come in a glass container which is sealed and as the closed container is placed in hot water (40° -60° C) the crystals liquify (supersaturated solution of phenol) and then one can add sterile water to the liquid to obtain a 85% - 90% solution of liquid phenol. Never use crystals directly on the skin rather reduce the concentration to approx 85%, As the temperature drops to below 20°C so the liquid tends to recrystalize (ie. in winter). Obviously the opened container needs to be handled with care. Don't inhale the fumes from a close distance. The best thing to do is to use small dark bottled containers - 25ml so as to reduce the risk of inhaling the fumes. The bottle is to be kept in a dark cupboard because the phenol degrades in the presence of light. When phenol comes into contact with skin it will blanch the skin in a few seconds, if this doesn't occur then the phenol is no longer suitable for phenolisation techniques ie. matrisectomies with phenolisation or VP chemotherapy can be unsuccessful.

Hope that answers your question

Maurizio Mazzoncini

Why not use NaOH? 10% solution for 20 seconds diluted with acetic acid offers less irritation and better resuts?

No reason why you shouldn't use 10% solution of NaOH, but the original questions was specific to Phenol.

Hi,
Could some one clear a couple of points up for me please?
I'm I right in thinking that you dilute the crystals in the original container with sterile water, then after use, the phenol recrystalises. So that this container is now in a state to be used again for the next treatment without the need to dilute it any more?

I take it that these crystals are always supplied in a 100% concentration and when liquified cant be applied directly in the use of nail surgery?

Thanks
Phil

Phil

The solution once diluted will remain at the same concentration even though it recrystallizes, but please note that when you heat the container to obtain a solution use hot water as a heat source rather than other forms of heat. Don't open the container as phenol is made of hydrols in the form of alcohol which evaporates during heating and reduces the concentration. I usually replace the phenol once every six months or when I notice that during the phenolisation the tissue doesn't blanch readily.

If you have any other queries please let me know
Maurizio

Maurizio

Many thanks for the quick response.
Phenol crystals seem like the way forward due to the shortage of liquid phenol and (cut off my nose to spite my face) I'm not about to buy the swabs; because of the monopoly on them, I feel Podiatrist are being 'ripped-off' slightly.

Phil

Hello Phil,

Just wishing to spread a note of caution to anyone having recently bought liquified phenol from Canonbury supplies UK.

I purchased 500ml 2 weeks ago & when it arrived I checked the date.

I was a little puzzled that it went OOD June 08!

I contacted Canonbury & they checked the dates on all their phenol in stock.

It all goes OOD in June this year.

I explained that 500ml of phenol with such a short shelf life is of little use to anyone other than someone in heavy industry.

I was granted a refund.

Just so people know to check the dates of any recently purchased stock.

Many regards,

__________________
:)
twirly

Mandy Brooks
Brooks Podiatry
S64 0DE

Suffering a fondness for odd things.

I always thought that the solvent was alcohol. In school I was taught to use alcohol to dilute the phenol after a phenol-alcohol nail.
When I get crystals, I just add a little bit of alcohol to dissolve the crystals. I always thought that as the solvent evaporates, the excessive phenol crystalizes. I may be wrong, as almost everything I was taught in school I have relearned over the years.

hi i am a bit confused about using these crystals, generally i apply the liquid but only have the crystals left in stock. Please can you expalin how you heat the crystals? is it by adding water? the crystals i have are contained in a closed plastic container so am unsure of how to proceed. sorry for you having to repeat yourselves once again.
many thanks.

hi,

during my training we always used phenol crystals directly to the area after nail surgery. by moistening a blacks file when checking the area for any 'bits', gets the instrument wet enough to pick up one crystal at a time and place under the eponychium to 'massage' in. applying about 2-3 crystals for a PNA is usually enough. the crystals 'melt' as you work them and as long as you are carful to avoid the fluid over riding on to the healthy skin around the nail edge, this woks well. i apply the crystals and work in for 3 x 1 min then wipe clear with a sterile gauze and blacks fileto remove excess phenol.

hope this helps

poppet

many thanks, the crystals i ahve are quite big, but may try this one. dissolving the crystals in distille dwater is ok, but i have no source to heat the distilled water without setting someones health and safety role or calling in the fire brigade! i have also found ordering phenol crystals very difficult!

hi,

i agree about the size of the crystals. i have been trying to think of a way of breaking them into smaller peices without causing them to fly around the room and burn someones eye out!

buying crystals is a difficult task. i cant remember where we got ours from but if i do i will pass on the info.

poppet

May I suggest warmed Sterile Saline instead of distilled water considering the use you are proposing for them?

Also why not just order liquid phenol 80%w/w? Much easier if you are having trouble as you state.

I have been using phenol crystals for 15 years undiluted with no adverse effects. Just melt the crystals by placing the glass jar in hot water (boiled water from a kettle) and then apply the liquified phenol directly to the sulcus using cotton wool buds on orange sticks. We apply 3 times for 60 seconds then irrigate the area with chlorhex in isopropyl alcohol (the pink stuff). It is easy to have your "aid" take the screw top lid off and replace it immediately to prevent inhalation of the fumes.

We have only seen localised phenol burns when care is not taken to wipe any spillage immediately with an absorbent gauze.

The results are far better than liquified phenol solutions, we have had less than 2% regrowth rate.

You can order phenol crystals through unichem pharmacists and they are significantly cheaper than all of the podiatry suppliers (EZ swabs are the most expensive I believe).

Hope this helps

Julian

It reckoned Elmsg:
I have experience of 27 years, using pure phenol in crystal, previously heated until blending it temporarily.
In principle with a burner of alcohol, subsequently with a gun of heat, and at present with micro-waves.
The rate of relapses is lower, by being found always to the same concentration.
Use the container of dark crystal and always they OPEN to heat.
Use gloves, mask and safety goggles.
It cover with vaseline the skin that surrounds the zone to try its patient.
Use atomizer of alcohol for accidental splashes and for the final wash after applying it in its patient.
I expect to have been useful.
Attentively:

Jose Antonio Teatino
Professor of Surgery
The Academy of Ambulatory Foot & Ankle Surgery