title: No-needle, single-visit adult male circumcision with Unicirc: a multi-centre field trial.
abstract: BACKGROUND
  Voluntary medical male circumcision (VMMC) is a priority HIV preventive intervention. Current adult circumcision methods need improvement.
  
  
  METHODS
  Field trial in 3 primary care centres. Minimally invasive VMMC using the Unicirc instrument following topical lidocaine/prilocaine anesthetic. Men were followed up at 1 and 4 weeks.
  
  
  RESULTS
  We circumcised 110 healthy volunteers. Two men complained of transient burning pain during circumcision, but none required injectable anaesthesia. Median blood loss was 1ml and median procedure time was 9.0 min. There were 7 (6.3%) moderate complications (5 (4.5%) post-operative bleeds requiring suture and 2 (1.8%) post-operative infections) affecting 7 men. No men experienced significant wound dehiscence. 90.4% of men were fully healed at 4 weeks of follow-up and all were highly satisfied.
  
  
  CONCLUSIONS
  Use of topical anaesthesia obviates the need for injectable anesthetic and makes the Unicirc procedure nearly painless. Unicirc is rapid, easy to learn, heals by primary intention with excellent cosmetic results, obviates the need for a return visit for device removal, and is potentially cheaper and safer than other methods. Use of this method will greatly facilitate scale-up of mass circumcision programs.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT02091726.
authors.affiliation: University of New England, Portland, Maine, United States of America.
authors.forename: Peter S
authors.initials: PS
authors.lastname: Millard
authors.affiliation: Faculty of Medicine and Health Sciences, Stellenbosch University and Department of Obstetrics and Gynaecology, Tygerberg Hospital, Cape Town, South Africa.
authors.forename: Norman D
authors.initials: ND
authors.lastname: Goldstuck
mesh_terms: D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage; D002944:Circumcision, Male / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D019106:Postoperative Hemorrhage / Q000209:etiology; D013019:South Africa; D013530:Surgical Wound Infection / Q000209:etiology; D013997:Time Factors; D014014:Tissue Adhesives / Q000008:administration & dosage; D014945:Wound Healing; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D014014:Tissue Adhesives
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