Paediatric sutureless circumcision--an alternative to the standard technique.
BACKGROUND
Circumcision is one of the most commonly performed surgical procedures in male children. A range of surgical techniques exist for this commonly performed procedure. The aim of this study is to assess the safety, functional outcome and cosmetic appearance of a sutureless circumcision technique.


METHODS
Over a 9-year period, 502 consecutive primary sutureless circumcisions were performed by a single surgeon. All 502 cases were entered prospectively into a database including all relevant clinical details and a review was performed. The technique used to perform the sutureless circumcision is a modification of the standard sleeve technique with the use of a bipolar diathermy and the application of 2-octyl cyanoacrylate (2-OCA) to approximate the tissue edges.


RESULTS
All boys in this study were pre-pubescent and the ages ranged from 6 months to 12 years (mean age 3.5 years). All patients had this procedure performed as a day case and under general anaesthetic. Complications included: haemorrhage (2.2%), haematoma (1.4%), wound infection (4%), allergic reaction (0.2%) and wound dehiscence (0.8%). Only 9 (1.8%) parents or patients were dissatisfied with the cosmetic appearance.


CONCLUSIONS
The use of 2-OCA as a tissue adhesive for sutureless circumcisions is an alternative to the standard suture technique. The use of this tissue adhesive, 2-OCA, results in comparable complication rates to the standard circumcision technique and results in excellent post-operative cosmetic satisfaction.
Department of Urology, Galway University Hospital, Galway, Ireland. drbriankelly@hotmail.com
Brian D
BD
Kelly
Dara J
DJ
Lundon
Marie E
ME
Timlin
Mazhar
M
Sheikh
Nadeem B
NB
Nusrat
Frank T
FT
D'Arcy
Syed Q
SQ
Jaffry
D002648:Child; D002675:Child, Preschool; D002944:Circumcision, Male / Q000379:methods*; D003487:Cyanoacrylates / Q000494:pharmacology*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013536:Suture Techniques; D014014:Tissue Adhesives / Q000494:pharmacology; D016896:Treatment Outcome
D003487:Cyanoacrylates; D014014:Tissue Adhesives; C100832:octyl 2-cyanoacrylate