Formation of less periorbital ecchymosis in post-operative period of rhinoplasty is a popular trend. We present the use of instantly crystallizing supercooled serum physiologic solution for periorbital cooling.
Physics of Supercooling
There are circumstances in which water temperature drops below its freezing point, but no phase transition happens while water remains in the liquid phase. This is called supercooling. Pure water can be supercooled below the freezing temperature without transforming into ice. Tap water will not supercool because it contains impurities that serve as nucleation sites for crystallization. For freezer temperatures in the range of − 4 °C, − 6 °C, and − 8 °C, nucleation was not observed and pure water remained in the supercooled condition for a long time.
Description of the Technique
Sterile serum physiologic solution at + 5 °C can be supercooled in the freezer at − 14 °C only between the 257 and 277 min time interval. But when it is supercooled in the freezer at − 8 °C it is possible to save it in liquid form for at least 7 days as we have observed in our trials.
Clinical Use and Discussion
It is easily possible to transform this supercooled liquid sterile serum physiologic within a few seconds into moldable snow-like ice that can be used safely and more nicely rather than solid ice for periorbital cooling in rhinoplasty operations. Its sterile inner bag is held tight and struck over the sterile nurse table and it crystallizes within a few seconds. For frozen solutions, tearing of the inner plastic bag and extracting the ice and then crushing of big masses of ice to small pieces is exhaustive and a time-consuming process. The temperature of the supercooled fluid will be zero at the moment of nucleation with no risk of frostbite. The crystallized serum physiologic solution preserves its ice-gel form for nearly 25 min.
The instant crystallization of supercooled liquid serum physiologic solution can be applied as a tissue cooling method in rhinoplasty and in several other surgical procedures.
Level of Evidence IV
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Conflict of interest
All authors declare that they have no financial disclosures no conflict of interest.
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Çerçi Özkan, A., Güven, E., Toktaş, B. et al. Supercooled Liquid Serum Physiologic Solution Instantly Crystallized on the Nurse Table Used for Cooling of Periorbital Region During Rhinoplasty. Aesth Plast Surg 43, 453–456 (2019). https://doi.org/10.1007/s00266-018-1287-7