circumplast

Circumcision (Khitan, Khatna) In Islam (Sunnah)

This practice is attributed to the Prophet Muhammad (pbuh). Therefore, circumcision acquired the status of Sunnah (Prophet’s tradition), although the tradition is attributed to the Prophet Abraham. Allah ordered Prophet Muhammad (pbuh) to follow the religion of Abraham (pbuh). When Allah says “Then we inspired you: ‘Follow the religion of your father Abraham, the upright in Faith.’ (Qur’an 16:123)”; and, thus, part of the religion of Abraham is circumcision.

The Pollock Technique for newborn male circumcision

The Pollock Technique for newborn male circumcision

  1. Liquid infant acetaminophen is administered orally 20 minutes before the procedure

  2. The room is heated to 25 °C to help keep the newborn warm

  3. A parent (or guardian) accompanies the child into the procedure room to help calm him, if he is distressed

  4. The newborn is secured onto a soft restraining board wearing a clean diaper

  5. The parent gives a grape-juice-soaked cotton ball to the infant orally to help soothe the newborn during the procedure 2.5 ccs of 0.5% Xylocaine is administered into the dorsal and ventral nerves of the penis eight minutes prior to the circumcision

  6. Hemostats are used to open adhesions from the foreskin to the glans to the level of the corona

  7. Hemostats are placed about two-thirds of the way up the foreskin

  8. The Mogen clamp is applied over the foreskin using the pair of hemostats as a guide

  9. The foreskin is excised with the #23 scalpel T

  10. he glans is liberated Hemostasis is promoted with pressure applied with Coban tape over gauze with petroleum jelly

  11. A blanket is used to help comfort the infant The infant is assessed after 15 minutes.

Reference: Rapid Training and Implementation of the Pollock Technique, a Safe, Effective Newborn Circumcision Procedure, in a Low-Resource Setting. Global Pediatric Health January-December 2015: 1–7 © The Author(s) 2015 DOI: 10.1177/2333794X15589114 gph.sagepub.com

Notes: The Pollock Technique for newborn male circumcision in not different from Mogen clamp circumcision. Mogen clamp is commonly used for Jewish circumcision (brit milah). Other methods for baby circumcision are Gomco clamp circumcision and forceps guided circumcision. In my experience, these methods are not superior to Circumplast or Plastibell circumcision in newborn circumcision.

The complications specific to Mogen clamp circumcision (Pollock Technique) include injury to the glans if it is not below the inferior edge of the clamp, and an asymmetric incomplete circumcision due to malpositioning of the clamp (typically more redundancy ventrally).

Reference: Complications of Circumcision: TheScientificWorldJOURNAL (2011) 11, 2458–2468 ISSN 1537-744X; doi:10.1100/2011/373829)

Baby Circumcision- Frequently Asked Questions

Baby Circumcision- Frequently Asked Questions

frequently ask questions about baby circumcision

London Circumcision Clinic by Paediatric Surgeon/Urologist  

Annual audit has improved outcomes of circumcisions

Annual audit has improved outcomes of circumcisions with disposable rings in children in a community clinic under local anaesthesia - Thornhill clinic and Leyton clinic, London


PURPOSE

To evaluate the early postoperative complications particularly impaction of disposable devices in children’s circumcision procedures under local anaesthesia in a community clinic in this year’s audit versus previous 3 audits. 

MATERIAL AND METHODS

In our current audit cycle, the outcome of circumcisions (n=1222) was prospectively studied over a 1-year period (May 2017 to April 2018) and were compared with the last 3 audit cycles. Circumcision was performed under local anaesthesia, by trained doctors in a community clinic using Circumplast (CC)(n=310) and Plastibell (PC)(n=912).  Early postoperative complications especially ring impaction were compared among the four audits. Follow-up was arranged if required.

RESULTS

The mean age was 4.4±0.3 months (median 1.5). Complication rate in this year’s audit was 5.1%(62/1222). There is no significant difference in overall complications rate in CC(6.8%n=21/310) versus PC(4.5%n=64/979)(p>0.5). Delayed ring separation/impaction is significantly lower in CC (1% n=3/310) versus PC (2.4% n=22/912) (p<0.05) and has significantly improved from the previous three audits. In current year, 202 (16.5%) children were followed and mean duration was 10±2.6 days (median 6).

CONCLUSIONS

The annually conducted audit has shown improved outcomes of circumcisions with disposable rings in children in a community clinic under local anaesthesia over successive years.

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Ref: Accepted as presentation and poster in ESPU 30th Meeting, Lyon, France.