ADEQUATE PERI-OPERATIVE MANAGEMENT DECREASES COSMETIC COMPLICATIONS AFTER CIRCUMCISION WITH DISPOSABLE RINGS (CIRCUMPLAST AND PLASTIBELL) IN CHILDREN
"We reviewed our experience in treating children with cosmetic complications following non-therapeutic male circumcision (NMC) with Plastibell and Circumplast devices at a community clinic. This study highlights the factors leading to these complications and clinical management to improve the cosmetic appearance.
A retrospective review of 3360 children who underwent Circumplast (CC) and Plastibell circumcision (PC) under local anaesthesia at a community clinic from May 2014 to October 2016. Parents were given detailed information and consented preoperatively in children with potential risks. This was provided verbally and in written format.
All complications were reviewed by a paediatric surgeon. All preputial adhesions were separated under anaesthetic cream. Buried penis was treated conservatively. Incomplete circumcisions were corrected by excision of excess skin. Acquired phimosis was treated by steroid, simple double incision of the scar and surgical reconstruction. Complications were further looked for CC and PC. Follow-up visits were arranged in all cases.
There is no significant difference in the complications between Circumplast Circumcision (2.2 % n=22/1002) and Plastibell circumcision (2.3% n= 55/2357). Preputial adhesions were higher in Plastibell Circumcision (1.5%) than Circumplast Circumcision (0.8%) but not statistically significant.
Children with cosmetic complications following NMC by disposable rings (Circumplast and Plastibell) can be prevented by meticulous perioperative management. Parental education and surgical expertise is required to minimise these complications"