Reliability of thermocautery-assisted circumcision: retrospective analysis of circumcision performed voluntarily in countries of low socioeconomic status

Comparison of hypochlorous acid and Povidone Iodine as a disinfectant in neonatal circumcision

INTRODUCTION

Neonatal circumcision is a procedure used worldwide which has very low rates of complication if conducted by a specialist. The present research aims to examine the wound healing effects of Hypochlorous Acid (HCOL) and Povidone Iodine (PI) used as a disinfectant prior to the procedure of circumcision and their antibacterial effectiveness.

MATERIAL AND METHOD

The findings of sixty infants subjected to neonatal circumcision at the Hisar Intercontinental Hospital between January 2021 and June 2021 were prospectively recorded. Based on the disinfectant used, the patients were divided into two group: Group 1 including 28 patients for whom HCOL was used as an antiseptic solution, and Group 2 including 32 patients to whom PI was administered.

RESULTS

Group 1 was formed of 28 patients while Group 2 included 32 patients. The mean ages of each group was 15.46 ± 10.58 (2-29) and 12.63 ± 10.00 (2-28) days, respectively. When the complications were examined individually, no significant difference was found between the groups. However, when all complications were analyzed collectively, it was determined that there was a significant difference, and the complication rate of Group 2 was greater (p = 0.037). In Group 2, the rate of edema and wound healing delay was significantly greater than that of Group 1 (p: 0.037 p: 0.036) (Table 1).

CONCLUSION

It was determined that HCOL is reliable to be used as a disinfectant prior to neonatal circumcision.

Cosmetic results of circumcision and scar wrinkling: Do we exaggerate in terms of hemostasis and sutures?

OBJECTIVE

To objective of this study was to investigate poor scar appearance of the circumcision line and scar wrinkling caused by the sutures placed during the circumcision in primary school age circumcised children.

METHODS

A total of 455 children aged between 6 and 9 years, circumcised by four different specialists in our hospital between 2009 and 2018 were evaluated. Circumcisions performed due to balanitis, phimosis, secondary phimosis, and paraphimosis were excluded from the study. Only routine religious circumcisions performed on request of the family were included in the study. Children underwent a second procedure and those receiving treatment after the circumcision due to infection were excluded from the study. About 363 patients included the study. Patients were evaluated according to the Fitzpatrick skin type classification, independent observer scale, Stony Brook Scar Evaluation Scale, and Dunn-Bonferroni test.

RESULTS

No statistically significant difference was found between distributions of scar wrinkling levels in children according to the circumcision (p > 0.05). There was a statistically significant difference between age of circumcision according to scare wrinkling levels (p = 0.001). According to the Dunn-Bonferroni test; the circumcision age was found to be significantly lower in children with severe scar wrinkling compared to the children with no or mild scar wrinkling (p = 0.001; p = 0.011).

CONCLUSION

The tense, short-interval sutures placed away from the wound margin during circumcision in order to control subcutaneous bleeding lead to scar wrinkling and a poor cosmetic appearance. Knowing the risk factors leading to scar wrinkling and taking appropriate measures will provide acceptable cosmetic outcomes after the circumcision.

Is it safe to use a thermocautery device for circumcision? Examination of the histopathological changes emerging after thermocautery-assisted circumcisions

Multiple number of techniques and devices have been described concerning circumcision method so far. One of them is thermocautery device, and it has been widely used. Although there is controversy that the penis may be damaged due to the heat generated during the use of the device, not enough histopathological studies have been conducted. We aimed to determine the histopathological changes in human foreskin caused by heat after circumcision with thermocautery and to demonstrate the safety of the use of a thermocautery-assisted circumcision. Forty-one patients were divided into two groups according to the thermal energy used during cutting with thermocautery as follows: high temperature (Group 1, n = 22) and low temperature (Group 2, n = 19). The effect of the heat intensity and depth of the coagulation necrosis produced with thermocautery-assisted circumcisions performed at low and high temperatures were evaluated. The difference between the groups was not statistically significant. Tissue damage is extremely limited in thermocautery-assisted circumcisions, even when it is used at high temperatures. The thermocautery device can be used for effective and safe circumcisions.