title: Plastibell Device Circumcision versus Bone Cutter Technique in terms of Operative Outcomes and Parent's Satisfaction.
abstract: OBJECTIVE
  To compare the rate of complications of Plastibell and bone cutter circumcision technique and recognition of top worries and satisfaction rate in the mind of parents before and after the procedure of Plastibell device (PD) circumcision in infants less than 6 months of age.
  
  
  METHODS
  It was a descriptive prospective study conducted at department of surgery Sheikh Zayed Hospital, Rahim Yar Khan. Two hundred parents of infants of less than six months of age were recruited for this study. Infants were divided into two equal groups. Group I included Plastibell circumcision technique and Group II included Bone Cutter Circumcision technique. Data was analyzed using SPSS Version 17. Independent sample t-test and chi-square test was used to compare quantitative and qualitative variables respectively. P-value <0.05 was taken as significant difference.
  
  
  RESULTS
  Total number of two hundred infants were included in this study. Most common worries of parents about Plastibell Device circumcision were; fear of fever (42.0%). Fear of pain and bleeding (66.0%). Plastibell Device method was associated with less operation time and bleeding as compared to bone cutter method (P-value <0.0001 and <0.0001 respectively). Incidence of complications other than bleeding and infection was 3.0% in bone cutter method and 1.0% in Plastibell device method. Pain score was significantly less in plastibell device group (p-value <0.0001). Post-operatively, 98% parents showed complete procedural satisfaction in Plastibell group versus 87% parents in bone cutter one month after surgery (P-value 0.003). About 4% parents in bone cutter method group showed cosmetic displeasure versus only 1% parents in plastibell device group.
  
  
  CONCLUSIONS
  The study concluded that Plastibell Device circumcision is a safer technique for circumcision and is associated with highest level of parent's satisfaction.
authors.affiliation: Tahir Mehmood, FCPS General Surgery. Senior Registrar Pediatric Surgery, Sheikh Zayed Medical College and Hospital, Rahim Yaar Khan, Pakistan.
authors.forename: Tahir
authors.initials: T
authors.lastname: Mehmood
authors.affiliation: Hammad Azam, FCPS General Surgery. Senior Registrar Cardiac Surgery, Sheikh Zayed Medical College and Hospital, Rahim Yaar Khan, Pakistan.
authors.forename: Hammad
authors.initials: H
authors.lastname: Azam
authors.affiliation: Muhammad Tariq, FCPS General Surgery. Senior Registrar Surgery, Bahawal Victoria Hospital, Bahawalpur, Pakistan.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Tariq
authors.affiliation: Zafar Iqbal, FCPS Peads. Surgery. Associate Prof. of Pediatric Surgery, Sheikh Zayed Medical College and Hospital, Rahim Yaar Khan, Pakistan.
authors.forename: Zafar
authors.initials: Z
authors.lastname: Iqbal
authors.affiliation: Hassan Mehmood, FCPS General Surgery. Professor of Surgery, Sheikh Zayed Medical College and Hospital, Rahim Yaar Khan, Pakistan.
authors.forename: Hassan
authors.initials: H
authors.lastname: Mehmood
authors.affiliation: Syed AsifHussain Shah, MBBS. Resident General Surgery, Sheikh Zayed Medical College and Hospital, Rahim Yaar Khan, Pakistan.
authors.forename: Syed Asif Hussain
authors.initials: SA
authors.lastname: Shah
keywords: Circumcision; Plastibell device; bone cutter method