CIRCUMCISION BY BONE CUTTER-IS IT SAFE?

Abstract

Objective: To determine the frequency of complications observed in circumcisions performed using closed method and to ascertain its safety in relation to pediatric penile trauma.

Study Design:Quasi-experimental study.

Place and Duration of Study:  Study was conducted in departments of surgery of combined military hospitals of Cherat, Khuzdar and Malir from Jan 2008 to Dec 2009.

Patients and Methods: Two hundred and fifty patients were included through the outpatient department for elective circumcision. Male children from 1 week of age to 1 year were included, circumcision being performed for ritual purpose. Exclusion criteria was those male children having deranged coagulation profile, neonatal jaundice, congenital urogenital abnormalities and any other disease. Circumcision was performed using closed technique by bone cutter.

Results: Out of the total 250 cases, the success rate of circumcision without any complication was recorded in 229 (91.6%) cases. The remaining 21 (8.4%) cases developed minor complications. Infection was recorded in 7 children (2.8%).Some degree of bleeding was observed in 10 (4%) cases which require change of dressing in 8 cases and haemostasis by application of stitches in 2 cases. Redo surgery was done in 4 (1.6%) cases for unsatisfactory cosmetic reasons. None of the patients in our study sustained trauma to glans.

Conclusion: Although it is not a standard procedure, Close method of circumcision by bone cutter is an established and safe technique if it is performed by trained practitioners. We suggest that training workshops should be organized to adequately train all practitioners of circumcision on the safe methods available.