Sutureless Adult Voluntary Male Circumcision with Topical Anesthetic: A Randomized Field Trial of Unicirc, a Single-Use Surgical Instrument.
BACKGROUND
The World Health Organization has solicited rapid and minimally invasive techniques to facilitate scale-up of voluntary medical male circumcision (VMMC).


METHODS
Non-blinded randomized controlled field trial with 2:1 allocation ratio.


METHODS
75 adult male volunteers.


METHODS
Outpatient primary care clinic.


METHODS
Open surgical circumcision under local anesthetic with suturing vs. Unicirc disposable instrument under topical anesthetic and wound sealing with cyanoacrylate tissue adhesive.


METHODS
Intraoperative duration.


RESULTS
Intraoperative and postoperative pain; adverse events; time to healing; patient satisfaction; cosmetic result.


RESULTS
The intraoperative time was less with the Unicirc technique (median 12 vs. 25 min, p < 0.001). Wound healing and cosmetic results were superior in the Unicirc group. Adverse events were similar in both groups.


CONCLUSIONS
VMMC with Unicirc under topical anesthetic and wound sealing with cyanoacrylate tissue adhesive is rapid, heals by primary intention with superior cosmetic results, and is potentially safer and more cost-effective than open surgical VMMC.


BACKGROUND
Clinicaltrials.gov NCT02443792.
Department of Epidemiology, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Justin
J
Shenje
Department of Epidemiology, Graduate Program in Public Health, University of New England, Portland, Maine, United States of America.
Peter S
http://orcid.org/0000-0002-7361-3356
PS
Millard
D000293:Adolescent; D000328:Adult; D000779:Anesthetics, Local / Q000627:therapeutic use; D002944:Circumcision, Male / Q000009:adverse effects / Q000379:methods*; D003487:Cyanoacrylates / Q000627:therapeutic use; D052816:Foreskin / Q000601:surgery; D006801:Humans; D008297:Male; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction; D014014:Tissue Adhesives / Q000627:therapeutic use; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult
D000779:Anesthetics, Local; D003487:Cyanoacrylates; D014014:Tissue Adhesives