Comparison between the bone cutter with thermal cautery, Gomco, and Plastibell for circumcision in neonates and infants: a prospective randomized trial

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Abstract

Background
Circumcision is the most common surgical procedure performed for a male newborn. This trial aimed to compare between three commonly used techniques for male circumcision in our institute.
Patients and methods
From January 2014 to January 2015, 150 babies were randomized into three groups according to the circumcision technique: babies circumcised using the bone-cutter forceps with thermal cautery (group I), Gomco clamp (group II), and the Plastibell device (group III). Intraoperative details, postoperative pain and complications, cosmetic outcome, and parent satisfaction were recorded.
Results
Operative time was significantly shorter for group I (<0.001). Postoperative dressing was needed in 50% of infants in group II compared with 12% in group I. Analgesic consumption was significantly lower in group I (<0.001). No significant differences were found between the three groups as regards the peer assessment score for the final cosmetic outcome. Parent satisfaction was significantly higher in groups I and II (=0.023). Infection was reported only in the Plastibell device group, and 10% had device-related complications.
Conclusion
The thermal cautery with bone-cutter technique proved superiority in hemostasis, operative time, and parent satisfaction, with less pain in the postoperative period. All three techniques had comparable final cosmetic outcome.

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