The Use of Tissue Glue for Circumcision in Children: Systematic Review and Meta-Analysis Published 2018

 Absract

Introduction

Tissue glue has been used for circumcision in children with promising results. We aimed to evaluate the efficacy of tissue glue in pediatric circumcision.

Materials and Methods

A systematic review and meta-analysis of the English literature (1997-2017) was conducted according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement on children that underwent circumcision with tissue glue. Meta-analysis was conducted using RevMan 5.3, Comprehensive Meta-Analysis 2 and MedCalc 18. P values < 0.05 were considered significant.

Results

The search returned 15 studies for a total 4567 circumcisions of which 3045 (66%) were performed with tissue glue. Systematic review: Overall complications rates were 4.3% (tissue glue) and 5.9% (sutures). Use of tissue glue was associated with reduced post-operative pain; better cosmetic results and reduced cost. Meta-analysis: There was no difference between the incidence of total post-operative complications (RR 0.86 [CI: 0.62 – 1.19]; p = 0.36]) and wound infection/dehiscence between the two groups (RR 0.95 [CI: 0.59 – 1.56]; p = 0.85). Post-operative bleeding/hematoma formation were reduced with the use of tissue glue (RR 0.55 [CI: 0.32 – 0.95]; p = 0.03). Tissue glue also significantly shorten the operative time (MD -0.22 [CI: -0.39 – -0.05]; p = 0.01).

Conclusions

Incidence of post-operative bleeding/hematoma formation in pediatric circumcision is reduced with the use of tissue glue. Tissue glue has reduced operative time; furthermore, it might be associated with reduced post-operative pain, less overall cost and superior cosmetic results.

Keywords

circumcision; children; tissue glue

Source: 

https://doi.org/10.1016/j.urology.2018.01.022