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 this year’s audit versus the previous three 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 compared with the last three audit cycles.
Circumcisions were 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
- Mean age: 4.4 ± 0.3 months (median 1.5).
- Complication rate in this year’s audit: 5.1% (62/1222).
- No significant difference in overall complication rate in CC (6.8% n=21/310) versus PC (4.5% n=64/979) (p>0.5).
- Delayed ring separation/impaction significantly lower in CC (1% n=3/310) versus PC (2.4% n=22/912) (p<0.05).
- Outcomes significantly improved compared to the previous three audits.
- In the current year, 202 (16.5%) children were followed; 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.