How do these people do studies that are so unethical? I think we need to write to the AAP. You would think pediatric urologists would speak out about the meatal stenosis that only circ'd boys suffer from. Baybee
Sutureless Circumcision Safe, Effective Alternative to Standard Procedure
Emma Hitt, PhD
Medscape Medical News 2006. © 2006 Medscape
October 12, 2006 (Atlanta) - Sutureless circumcision with 2-octyl
cyanoacrylate (2-OCA, Dermabond) appears to be a safe and cosmetically
appealing alternative to standard suturing, according to the findings of a
new study.
Andrew J. Kirsch, MD, and colleagues from Emory University and Children's
Health Care of Atlanta, Georgia, presented the findings here at the American
Academy of Pediatrics National Conference and Exhibition.
The researchers evaluated the sutureless procedure in 70 patients (average
age, 4 years). Of those, 59 underwent circumcision, and 11 underwent
circumcision revision with the use of 2-OCA for skin closure.
Circumcision was conducted using a sleeve technique (n = 57) or a Gomco
clamp (n = 13). The incision was first cleaned after hemostasis, and the 2
skin edges were aligned. Next, 2 thin layers of 2-OCA were applied to the
edges and allowed to dry. The glans and penis were then treated with
antibiotic ointment.
The average skin closure time was 3 minutes overall, but for the last 20
patients, the closure time was less than 90 seconds, indicating improved
technique over time. After a mean follow-up of 3.4 months no intraoperative
or postoperative complications were observed.
Subjectively, cosmetic outcomes appeared to be better than those observed
with standard procedures, with no risk of suture tracks or sinuses,
according to researchers. In addition, parents seemed to be satisfied with
the procedure.
Dr. Kirsch pointed out that sutureless circumcision is not appropriate for
all patients. "If sutures or dressings for hemostasis or tissue alignment
are required, then sutureless circumcision is not appropriate," he told
Medscape.
"In addition, the cost is higher with the sutureless technique; however, if
15 minutes can be saved per case, major cost benefits should be realized,"
Dr. Kirsch added. A direct cost and outcome comparison between the 2
techniques is underway.
"The cosmetic appearance and lack of suture-related wound healing issues
still makes the additional small cost worthwhile, and [we] have made it our
procedure of choice at our institution," he said.
Martin A. Koyle, MD, chief of pediatric urology at The Children's Hospital,
in Denver, Colorado, reported using the sutureless circumcision technique in
his practice. "It is a quick and easy technique and is an option to current
delayed circumcision modes," Dr. Koyle told Medscape. "We have also used
this technique for hypospadias as well," he said.
He noted that he would not use the sutureless technique in the case of a
hidden penis. "We have personally had experience where the penis drops back
again, and so we only use this technique for classical circumcision
indications," he said.
The author reports no relevant financial relationships.
AAP 2006 National Conference & Exhibition: Abstract 475. Presented October
7, 2006.
Sutureless Circumcision Safe, Effective Alternative to Standard Procedure
Emma Hitt, PhD
Medscape Medical News 2006. © 2006 Medscape
October 12, 2006 (Atlanta) - Sutureless circumcision with 2-octyl
cyanoacrylate (2-OCA, Dermabond) appears to be a safe and cosmetically
appealing alternative to standard suturing, according to the findings of a
new study.
Andrew J. Kirsch, MD, and colleagues from Emory University and Children's
Health Care of Atlanta, Georgia, presented the findings here at the American
Academy of Pediatrics National Conference and Exhibition.
The researchers evaluated the sutureless procedure in 70 patients (average
age, 4 years). Of those, 59 underwent circumcision, and 11 underwent
circumcision revision with the use of 2-OCA for skin closure.
Circumcision was conducted using a sleeve technique (n = 57) or a Gomco
clamp (n = 13). The incision was first cleaned after hemostasis, and the 2
skin edges were aligned. Next, 2 thin layers of 2-OCA were applied to the
edges and allowed to dry. The glans and penis were then treated with
antibiotic ointment.
The average skin closure time was 3 minutes overall, but for the last 20
patients, the closure time was less than 90 seconds, indicating improved
technique over time. After a mean follow-up of 3.4 months no intraoperative
or postoperative complications were observed.
Subjectively, cosmetic outcomes appeared to be better than those observed
with standard procedures, with no risk of suture tracks or sinuses,
according to researchers. In addition, parents seemed to be satisfied with
the procedure.
Dr. Kirsch pointed out that sutureless circumcision is not appropriate for
all patients. "If sutures or dressings for hemostasis or tissue alignment
are required, then sutureless circumcision is not appropriate," he told
Medscape.
"In addition, the cost is higher with the sutureless technique; however, if
15 minutes can be saved per case, major cost benefits should be realized,"
Dr. Kirsch added. A direct cost and outcome comparison between the 2
techniques is underway.
"The cosmetic appearance and lack of suture-related wound healing issues
still makes the additional small cost worthwhile, and [we] have made it our
procedure of choice at our institution," he said.
Martin A. Koyle, MD, chief of pediatric urology at The Children's Hospital,
in Denver, Colorado, reported using the sutureless circumcision technique in
his practice. "It is a quick and easy technique and is an option to current
delayed circumcision modes," Dr. Koyle told Medscape. "We have also used
this technique for hypospadias as well," he said.
He noted that he would not use the sutureless technique in the case of a
hidden penis. "We have personally had experience where the penis drops back
again, and so we only use this technique for classical circumcision
indications," he said.
The author reports no relevant financial relationships.
AAP 2006 National Conference & Exhibition: Abstract 475. Presented October
7, 2006.
