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Annual Audit Improves Circumcision Outcomes in Children

By: Dr. Khan

Published: January 5, 2019

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.

Dr. A.R Khan

Paediatric Surgeon/Urologist

Bio

BSC, MBBS, FRCS, FEBPS, FRCS (PAEDS)
Dr. Khan is a highly experienced and respected paediatric surgeon and urologist with a distinguished career that spans over three decades. He has performed more than 7,000 circumcisions in the UK and is recognised for his expertise in treating foreskin problems, buried penis, and hypospadias. Dr. Khan is also pioneering new techniques in circumcisions for adults, children, and infants, ensuring the highest standards of care for his patients.
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