title: Comparative evaluation of two techniques of hemostasis in neonatal circumcision using the Plastibell device.
abstract: OBJECTIVE
  To evaluate the safety of the Plastibell neonatal circumcision technique and the incidence of complications in Iranian neonates.
  
  
  METHODS
  In this study, 7510 term neonates born between 2001 and 2006 in Rafsanjan medical centers, with age range of 3-36h, were randomized into two groups. In group A (3760 cases), an incision was made in the dorsal surface of the prepuce and then 3min frenular manual compression was performed with a sponge. In group B (3750 cases), frenular hemostasis was achieved using ophthalmologic thermal cautery. The two groups were compared in terms of complications of hemorrhage, wound infection, urine retention and delayed wound healing.
  
  
  RESULTS
  In group A, bleeding occurred in 15 cases (0.4%), and in group B in two cases (0.05%). The bleeding rate in group A was significantly higher (P=0.002). In group A, urinary retention was seen in 12 cases (0.03%), in comparison to 35 cases (0.9%) in group B. This complication rate was significantly higher in group B (P=0.001). Local or systemic infection was not seen in either group.
  
  
  CONCLUSIONS
  Although using thermal cautery we have less bleeding, the total complication rate is increased significantly.
authors.affiliation: Department of Urology, Kamkar Hospital, Qom Medical Sciences University, School of Medicine, Qom, Iran. moslemi_urologist@yahoo.com
authors.forename: Moslemi Mohammad
authors.initials: MM
authors.lastname: Kazem
authors.forename: Abedin Zadeh
authors.initials: AZ
authors.lastname: Mehdi
authors.forename: Kholaseh Zadeh
authors.initials: KZ
authors.lastname: Golrasteh
authors.forename: Feis Zadeh
authors.initials: FZ
authors.lastname: Behzad
mesh_terms: D016063:Blood Loss, Surgical / Q000517:prevention & control*; D017115:Catheter Ablation / Q000295:instrumentation*; D002944:Circumcision, Male / Q000379:methods*; D004867:Equipment Design; D005500:Follow-Up Studies; D006488:Hemostasis, Surgical / Q000295:instrumentation*; D006489:Hemostatic Techniques / Q000295:instrumentation*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007492:Iran / Q000453:epidemiology; D008297:Male; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000517:prevention & control*; D012189:Retrospective Studies; D016896:Treatment Outcome