title: Paediatric sutureless circumcision and modified circumcision: video demonstration.
abstract: OBJECTIVE
  Circumcision is undertaken using a variety of surgical methods. Modified circumcision for the hooded prepuce or mild glanular hypospadias mandates an excellent cosmetic result. Tissue glue is an alternative to sutures for circumcision in children and has significant advantages in terms of cosmesis and postoperative pain. We present two detailed videos demonstrating our technique for sutureless circumcision and modified circumcision.
  
  
  METHODS
  The incisions were marked on the outer and inner preputial skin. Incisions were made with a scalpel. Complete haemostasis was ensured. Tissue adhesive was placed onto the wound using a 32-gauge needle to allow controlled application. It is important to ensure that the coronal sulcus is free of glue at the end of the procedure. Once the circumcision is complete the penis can be cleaned and temporarily dressed.
  
  
  RESULTS
  Between November 2008 and September 2011, we have used this technique for 57 circumcisions and 30 modified circumcisions. No complications occurred. All were followed up for a minimum of 3-6 months.
  
  
  CONCLUSIONS
  The technique allows reproducible excellent cosmetic results, can be easily taught to junior surgical staff and should be considered as an alternative to a standard sutured circumcision.
authors.affiliation: Department of Paediatric Surgery & Urology, St George's Hospital, Blackshaw Road, Tooting, London SW17 0QT, UK. neilfeatherstone@doctors.org.uk
authors.forename: Neil C
authors.initials: NC
authors.lastname: Featherstone
authors.forename: Feilim L
authors.initials: FL
authors.lastname: Murphy
mesh_terms: D002648:Child; D002675:Child, Preschool; D002944:Circumcision, Male / Q000379:methods*; D004659:Enbucrilate / Q000494:pharmacology*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D010149:Postoperative Pain / Q000517:prevention & control; D015203:Reproducibility of Results; D013536:Suture Techniques; D016896:Treatment Outcome
chemical_list: D004659:Enbucrilate