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th
CONGRESS OF THE ESPU
16:42–16:45
S12-3 (PP)
RE-AUDIT OF EARLY COMPLICATION ESPECIALLY
IMPACTION OF DISPOSABLE DEVICE: IMPROVING
OUTCOMES OF CIRCUMCISIONS WITH PLASTIBELL
AND CIRCUMPLAST RINGS IN CHILDREN IN A COMMUNITY
CLINIC
Abdul Rauf KHAN, Mohammed AMIN, Darrel GREGORY, Samantha HARRISON and
Murtaza KHANBHAI
Thornhill Circumcision Centre, GP surgery, Luton, UNITED KINGDOM
PURPOSE
To evaluate the early postoperative complications particularly impaction of disposable devices in
children’s circumcision procedures under local anaesthesia between different age groups, size and
types of rings, and different doctors in a community clinic.
MATERIAL AND METHODS
In our re-audit, the outcome of circumcisions (n=1449) was studied over a 1 year period (May
2016 to April 2017) performed under local anaesthesia, by trained doctors in a community clinic
doing Circumplast Circumcisions (CC)(n=470) and Plastibell circumcisions (PC)(n=979). Data
was collected prospectively and early postoperative complications especially ring impaction were
compared between age of the child, size and types of device, and doctors who have performed the
circumcision. Follow-up was arranged if required.
RESULTS
The mean age was 6.5±0.4 months (median 1.6). Overall complication rate was 6.7 % (97/1449).
There is no significant difference in overall complications rate in CC (7 %n=33/470) versus PC
(6.5 %n=64/979) (p>0.5). Although ring impaction is significantly lower in CC (0.4 %n=2/470)
versus PC (3.4 %n=33/979) (p<0.05) but it has significantly improved from the previous audit (CC
3.2 % n=7/208 versus PC 8.7 % n=102/1179 – ESPU 2016). There is significantly lower incidence
in ring impaction with Plastibell size 1.4 as compared to 1.3, 1.5 and 1.7. There is no impaction in
1.1 and 1.2 sizes. Ring impaction was significantly lower in infants versus over 1 year child (1.5 %
vs 10 % n= 19/1280 vs 17/169, p<0.5) respectively. There is no significant difference in complica-
tions (8.5 %, 7.1 %, 6.5 %, 5.8 % and 5 %) among the five doctors’ cases (p>0.5). Mean follow-up
for 354 (24 %) children were 14 days (median 6).
CONCLUSIONS
This concludes that no significant difference noted in overall early complications of circumcisions
between age of the child, size and types of device used, and among different doctors. However, ring
impaction was significantly lower in infants, Plastibell size 1.4 and Circumplast.
16:45–16:54
Discussion