Disposable Circumcision Suture Device Research Articles

Disposable circumcision suture device: A potential bedside tool for circumcision – A series of 18 cases

Male circumcision (MC) is a well-established surgical procedure with a long history. It offers various health benefits, including protection against infections and diseases. The disposable circumcision suture device (DCSD) helps in faster wound healing which will result in reduced complications compared to other conventional circumcision methods. In this report, we share our experience with the stapler method in MC for various dermatological indications. The study emphasized the significance of circumcision in dermatological applications and its potential impact on clinical practice.

Frenulum Protection Technique in Disposable Circumcision Suture Device for Adult Males.

To evaluate the efficacy of frenulum protection technique of the disposable circumcision suture device (DCSD) in adult males. Atotal of 53 adult males were diagnosed with redundant prepuce and underwent circumcision with DCSD using frenulum protection technique. The main preoperative and postoperative measure of the length of penile frenulum was evaluated. Other data such as edema rate, intraoperative blood loss, operation time, postoperative pain, staple falling off time, incision infection rate, and evaluation of satisfaction rate with penis appearance were documented in the study. There was no significant difference in preoperative and postoperative frenulum length for each patient. The mean length of the penile frenulum before and after surgery was 2.25 ± 0.36 cm and 2.23 ± 0.39 cm, respectively (p = .31). The rate of frenulum length preservation was 100%. All the patients had no excessive resection of the frenulum and no serious complication happened after surgery. The satisfaction rate of postoperative penis appearance from patients' evaluation was 98.1% (52/53). The frenulum protection technique was simple and operable, which could help the operator to accurately identify the most distal position of the frenulum and retain a sufficient length of frenulum during DCSD circumcision.

A Retrospective Taiwanese-Population-Based Clinical Study on Determining the Efficacy and Safety of Disposable Circumcision Anastomat.

Traditional approaches for male circumcision are tedious and could lead to complications such as peri-/postoperative pain, bleeding, and infection. Thus, for the first time, we investigated the surgical outcomes of recently the discovered Disposable Circumcision Anastomat Type A (Dongguan ZSR Biomedical Technology Company Ltd., China), a disposable circumcision suture device (DCSD), in terms of the operation time, surgical complexity, safety, satisfaction, and aesthetic outcomes and most importantly the prognostic factors for postoperative infection. A total of 394 individuals were circumcised, with a mean age, body mass index (BMI), stretched penile length (SPL), and penile circumference of 30.1 ± 7.05 years, 25.47 ± 4.73, 10.12 ± 1.61, and 7 ± 0.73 cm, respectively. Associated comorbidities included diabetes mellitus (6.09%), hypertension (2.03%), gout (1.02%), end-stage renal disease (ESRD, 0.25%), and HIV (0.25%). The mean operation time, average postoperative bleeding, and wound infection rate was 31.4 ± 9.96 min, 2.54%, and 9.39%, respectively. The mean VAS postoperative pain scores at D0 and D1 were 4.4 ± 2.4 and 1.9 ± 1.6, respectively. Moreover, 1.27% of subjects required reoperation, and a 2.03% rate of instrument malfunction was noted. The significant factors associated with the post-operative infection group were age (p = 0.0313), BW (p = 0.0081), BMI (p = 0.0026), penile circumference (p = 0.0343), and DM (p ≤ 0.001). Multivariate analyses revealed only DM as a statistically significant factor (p < 0.001). Our box–whisker plot revealed no significant difference between the HbA1c level of infection (Hb1Ac = 7.77 ± 1.39) and non-infection groups (Hb1Ac = 6.92 ± 1.84). However, a trend of higher glycemic index in the infection group was observed. Conclusively, DSCD could be an effective and safe alternative to performing circumcision. However, in the population with advanced aging, phimosis, elevated BMI, and DM (HbA1C > 9%), users should be highly cautious due to the increased risk of infection, dehiscence, and hematoma.

A Modified Disposable Circumcision Suture Device with Application of Plastic Sheet to Avoid Severe Bleeding After Circumcision.

To evaluate the effectiveness of a modified disposable circumcision suture device (DCSD) with application of plastic sheet to avoid severe bleeding after circumcision and compare the surgical effects and other postoperative complications of two DCSDs. A total of 943 excess foreskin patients from January 2018 to January 2020 who underwent circumcision using two different DCSDs were recruited. Preoperative characteristics (patient age, height and weight), main surgical outcomes (surgical time, intraoperative blood loss, incision healing time) and postoperative complications (postoperative hemorrhage and hematoma rate, edema rate, incision infection rate, residual staples rate) were collected and analyzed. Patients' "satisfaction" or "dissatisfaction" was also investigated. Preoperative characteristics showed no significant statistical difference. The modified DCSD group has a lower intraoperative bleeding, postoperative hemorrhage or hematoma rate and residual staples rate compared with the conventional group. Incision healing time and incision infection rate between the two groups were similar. Nevertheless, conventional group has a shorter surgical time, a lower edema rate and a higher satisfaction rate. The modified DCSD with application of plastic sheet can avoid severe bleeding after circumcision effectively and can be served as a new choice for circumcision.

A Modified Pressure Dressing to Avoid Severe Bleeding After Circumcision With a Disposable Circumcision Suture Device and a Discussion on the Mechanism of Bleeding With the Disposable Circumcision Suture Device.

IntroductionA novel type of a disposable circumcision suture device (DCSD) has been proved to be effective and safe; however, a few cases of severe bleeding took place after circumcisions.AimTo evaluate the effectiveness of a modified double-layer pressure dressing to avoid severe bleeding after circumcision with the DCSD, in our department in a prospective randomized controlled study, and discuss the mechanism of bleeding with DCSD.MethodsPatients with redundant foreskin or phimosis were included between September 2018 and November 2019 and divided into 2 groups: In group A, the conventional pressure dressing was performed; in group B, an modified double-layer pressure dressing was performed.Main Outcome MeasureThe main outcomes and complications (surgical time, incidence of glans ischemia, severe bleeding rate, infection rate, pain level, total cost, and overall satisfaction) were collected and analyzed.ResultsA total of 624 patients were recruited for this study. There was no difference in the average age and body mass index between 2 groups. No patient suffered obvious glans ischemia. In group B, lower pain level, lower incidences of severe bleeding, and better satisfaction were recorded.ConclusionThe mechanism of bleeding with the DCSD was discussed in this study, and the modified pressure dressing was proved effective, safe, and easy to perform.W Jiang, J-li Fu, W-l Guo, et al. A Modified Pressure Dressing to Avoid Severe Bleeding After Circumcision With a Disposable Circumcision Suture Device and a Discussion on the Mechanism of Bleeding With the Disposable Circumcision Suture Device. Sex Med 2021;9:100288.

Modified Circumcision Using the Disposable Circumcision Suture Device in Children: A Randomized Controlled Trial

ObjectiveTo evaluate and compare the surgical outcomes and complications of the modified circumcision using disposable circumcision suture device (device group) and the conventional dorsal slit circumcision (conventional group) in children. MethodsA total of 284 patients were randomized to either device group or conventional group. All patients were preoperatively assessed and evaluated at 4 weeks after surgery. The perioperative data and postoperative outcomes were compared between the 2 groups. ResultsNo statistical differences were observed in the average age and indications between the 2 groups preoperatively (P > .05). Compared with the conventional group, patients in the device group were shorter mean operative time, less blood loss, lower intraoperative and postoperative pain score, faster incision healing time and a higher satisfaction rate of penile cosmetic appearance (P < .01). Similarly, the incidences of complication were significantly lower in the device group than in the conventional group (4.3% vs 12.3%, P < .05). ConclusionsThe modified circumcision using disposable circumcision suture device is a simple, safe, faster, and effective procedure and may become the attractive alternative to the conventional technique for the children, with a relatively lower complication rate and better cosmetic results. With the improvement of disposable circumcision suture device, the modified circumcision using disposable circumcision suture device has the potential to be widely used in the world.

Clinical curative effect analysis of disposable circumcision suture device Versus Shang Ring circumcision and Traditional circumcision

Objective To compare the efficacy and safety of disposable circumcision suture device (DCSD), ShangRing circumcision and traditional circumcision in the treatment of patients with redundant prepuce or phimosis. Methods All the 620 patients with redundant prepuce or phimosis were randomly divided into three groups: the DCSD group(n=280) and the ShangRing group(n=210) and the traditional circumcision group(n=130). Factors concerning efficacy and safety were compared. Results DCSD showed obvious advantages of the ShangRing and the traditional circumcision in operating time(6.1±0.8), (8.5±1.7), (30.1±0.5)min, intraoperatve blood soss (1.0±0.0), (1.0±0.0), (5.0±1.0)mL, wound healing time (14.5±1.5), (18.5±2.0), (13.5±1.5)d, postoperative pain score (1.94±1.08), (3.89±0.98), (4.20±0.58). The incidence of postoperative hematoma was 2.29%, 2.25%, 1.52%, and post operation edema rate was 8.04%, 25.89%, 30.89%.There was significant difference in above results (P<0.05). Conclusions DCSD has advantages of shorter operation and incision healing time, reduced postoperative pain score, and high appearance satisfaction.It should be widely used in clinical practice. Key words: Foreskin; Phimosis; Circumcision, Male

Clinical effectiveness of disposable circumcision suture in children: a prospective randomized controlled trial

To assess the clinical efficacy of disposable circumcision suture device (DCSD) in children receiving circumcision. Children with phimosis and redundant prepuce undergoing circumcision in our hospital were prospectively enrolled in this study hospital and randomized into DCSD group and conventional circumcision (CC) group. A total of 236 boys were enrolled, including 132 in DCSD group and 104 in CC group. The use of local anesthesia, operation time, intraoperative blood loss, intraoperative and postoperative pain scores, penile appearance satisfaction rates, postoperative complications, healing time of the incision, and the overall satisfaction rate were compared between the two groups. Compared with CC group, DCSD group had a significantly higher proportion of local anesthesia (P < 0.01), shorter operative time (P < 0.001), less intraoperative blood loss (P < 0.001), lower intraoperative and postoperative pain scores (P < 0.001), higher penile appearance satisfaction rates (P=0.03), less postoperative complications (P=0.04), shorter healing time (P < 0.001), and a higher overall satisfaction rate (P < 0.005). The use of DCSD can shorten the operative time and is associated with good tolerance of local anesthesia, less pain, quick recovery, and higher penile appearance satisfaction rates in children receiving circumcision.

Disposable circumcision suture devices versus Shang ring circumcision for management of redundant prepuce or phimosis: A systematic review and meta-analysis

ObjectiveTo evaluate the clinic efficacy and safety of the disposable circumcision suture device (DCSD) and Shang ring circumcision (SRC) in the treatment of redundant prepuce or phimosis with a meta-analysis. Material and methodsElectronic databases including PubMed, Embase, Wan Fang, VIP, CNKI and CBM database were researched from inception to August 30, 2016 for relevant RCTs and prospective studies, the reference lists of the included studies were also searched manually. The risk ratios (RR) or mean difference (MD) with 95% confidence intervals (CI) as the effect sizes were calculated by the Revman 5.3 and stata12.0 software. ResultsTwelve RCTs or prospective studies were included with 3345 patients among which 1661 cases received DCSD treatment and 1684 SRC. Compared to the Shang ring circumcision treatment, the disposable circumcision suture device provided a significantly shorter operation time [MD=−0.94, 95%CI (−1.76, −0.12), P=0.02], lower pain scores [MD=−1.89, 95%CI (−2.72, −1.07), P<0.001], no stitch removal pain, better postoperative penile appearance [RR=1.10, 95%CI (1.04, 1.17), P=0.001], fewer complications [RR=0.42, 95%CI (0.32, 0.56), P<0.001] and shorter wound healing time [MD=−8.92, 95%CI (−10.79, −7.05), P<0.001]. Meanwhile, there is more intraoperative blood loss [MD=0.12, 95%CI (0.02, 0.22), P=0.02], and more treatment cost [MD=877.57, 95%CI (737.94, 1017.20); P<0.001]. ConclusionsBased on the results of our meta-analysis, DCSD is more effective and safer than SRC. Thus, it has the advantages of shorter operation time, lower pain scores, better postoperative penile appearance, fewer complication and shorter wound healing time. However, the results need additional high-quality multicenter RCTs to evaluate in the future.

Comparative effect of dorsal slit circumcision and disposable circumcision suture device

Objective To compare the safety and effectiveness of disposable circumcision suture device (DCSD) with conventional circumcision in surgical treatment of phimosis and redundant prepuce. Methods One hundred and sixty one patients with phimosis or redundant prepuce were randomly assigned to be treated by circumcision using disposable circumcision suture device (DCSD group, n=89) or conventional circumcision (CC group, n=72), respectively. Results The operation time was (3.8±0.5)min in DCSD group and (31.6±2.7)min in CC group (F=71.21, P=0.000), blood loss was 1.0(0.9, 1.2)ml in DCSD group and 6.2(5.7, 7.0)ml in CC group (Z=-10.90, P=0.000). There were no significant differences in intraoperative pain score (1.4±0.6 vs. 2.9±0.8, F=2.08, P=0.151) and wound healing time [(14.0±1.3) vs. (16.8±2.1) d, F=0.10, P=0.754] between two groups. There was no need to change the dressing for patients in DSCD group 3 days after the operation, while patients in CC group changed dressing 3 times after the operation. No significant differences in postoperative complication rate [10%(9/89) vs. 4%(3/72), χ2=2.04, P=0.153] and satisfaction rate with the penile appearance [98%(87/89) vs. 94%(68/72), χ2=0.47, P=0.494] were found between two groups. Conclusion DCSD exhibits superiority over CC for shorter operation time and less blood loss in circumcision. Key words: Circumcision, male; Phimosis; Surgical stapling

Clinical application of disposable circumcision suture device (DCSD) versus ShangRing circumcision in male circumcision

Objectives To compare the efficacy and safety of disposable circumcision suture device (DCSD) and ShangRing circumcision in the tratment of patients with redundant prepuce or phimosis. Methods 180 patients with redundant prepuce or phimosis were randomly divided into two groups: the DCSD group (n=93) and the ShangRing group (n=87). Factors concerning efficacy and safety were compared. Results DCSD showed obvious advantages over the ShangRing in operating time [(6.36±1.09)min vs. (7.23±1.10) min], postoperative 24h pain score (1.94±1.08) vs.(2.89±0.98), postoperative 7d pain score (2.08±0.89) vs. (3.74±1.01), wound healing time [(18.44±3.58)d vs. (21.66±3.65)d], the incidence of wound dehiscence (2.2% vs. 11.5%), and overall satisfactory rate (86.0% vs. 73.6%). There was significant difference in above results (P 0.05). Conclusions DCSD has advantages of shorter operation and incision healing time, reduced postoperative pain score, and high appearance satisfaction. It should be widely used in clinical practice. Key words: Circumcision, Male; Surgical Staplers

Applications of disposable circumcision stapler with lidocaine cream combined with lidocaine injection anesthesia in circumcision

Objective To investigate the application efficacy of disposable circumcision stapler with compound lidocaine cream combined with lidocaine injection in the circumcision. Methods From September 2013 to November 2014, 120 cases (11 cases of redundant prepuce phimosis patients), were divided into disposable circumcision suture group (S group, 60 cases) and conventional circumcision (T group, 60 cases), two groups had no statistically significant difference at patient age and wrapping case (6 cases phimosis of S group, 5 cases phimosis of T group)(P>0.05. Patient's age ranged from 11 to 49 years. 30 patients in each group were treated with lidocaine cream combined with lidocaine injection, and another 30 patients were treated with a local anesthetic lidocaine injection. Comparisons were conducted among the four groups on the operation time, anesthesia, intraoperative and postoperative pain score, blood loss and postoperative complications, postoperative appearance satisfaction, wound healing time. Results For the disposable circumcision stapler with lidocaine cream combined with lidocaine injection group, disposable circumcision stapler with lidocaine injection group, sleeve circumcision with lidocaine cream combined with lidocaine injection group and sleeve circumcision with lidocaine injection group, the operation time was (5.3±1.5)min, (4.9±1.4)min, (31.6±3.4)min, (32.0±3.3)min respectively, blood loss was (0.6±0.4)ml, (0.8±0.5)ml, (6.9±2.4)ml, (7.5±2.1)ml respectively, narcotic pain score was 0.6±0.6, 3.2±3.9, 2.5±1.0, 0.5±0.6, intraoperative pain score was 0.8±0.9, 1.4±0.8, 2.2±1.1, 3.1±1.1, postoperative 24 h pain score was 1.6±0.9, 2.2±0.8, 2.6±1.3, 4.4±1.1, postoperative 48h pain score was 0.7±0.6, 0.8±0.9, 2.4±0.8, 2.8±0.7, wound healing time was (13.7±1.5)d, (13.5±1.7)d, (14.2±1.3)d, (14.1±1.6)d, the rate of postoperative complications was 6.6% (2/30), 10.0%(3/30), 26.6%(8/30), 33.4%(10/30), satisfaction rate of appearance was 93.4%(28/30), 96.7%(29/30), 70.4%(22/30), 80.0%(24/30). Compared with sleeve circumcision with lidocain injection group, disposable circumcision stapler with lidocaine cream combined with lidocaine injection had a shorter operation time, less pain, less bleeding, higher appearance satisfaction rate and lower incidence of complications (P 0.05). Conclusion Application of the disposable circumcision stapler with lidocaine cream combined with lidocaine injection on circumcision is safe and has got better clinical outcomes. Key words: Redundant prepuce; Disposable circumcision suture device; Compound lidocaine cream; Lidocaine injection

Comparative study of the circumcision techniques curative effect between circumcision suture device and Shang Ring

Objective To compare the clinical effectiveness among disposable circumcisionsuture device and Shang Ring in treating redundant prepuce and phimosis. Methods The clinical data of 224 cases of circumcisions done by disposable circumcision suture device(n= 112)and Shang Ring(n= 112) were retrospective1y analyzed.Operation time,intra-operational bleeding and postoperative complications among two techniques were compared. Results Disposable circumcision suture operation and Shang ring circumcision without significant difference in the operation time and intra-operational bleeding.There result was(6.1±0.8)min vs(6.5±1.7)min and(2.0±0.0)mL vs(1.8±0.0)m L(P> 0.05).The incidence of postoperative complications with incision pain rate was 21.43% vs 50.89%,infection rate was 14.29% vs 6.25%,frenum area incision edema rate was 8.04% vs 25.89%,and the postoperative hematoma and healing time was(8.0±1.7)d vs(14.0±1.2)d,the differences were statistically significant(P<0.05). Conclusion Each of two techniques has its own advantages and disadvantages.The treatment decision making should be a detailed description to the patients,we propose that school -age children should choose Shang Ring built-in method and the others should use disposable circumcision suture device depending on the situation. Key words: Circumcision; Shang Ring; Circumcision suture device

Disposable circumcision suture device: clinical effect and patient satisfaction.

In our experience patients undergoing circumcision are mostly concerned about pain and penile appearances. We conducted a prospective randomized trial to assess the benefits of a new disposable circumcision suture device (DCSD). A total of 942 patients were equally divided into three groups (conventional circumcision, Shang ring and disposable suture device group). Patients in the DCSD group were anesthetized with compound 5% lidocaine cream, the others with a 2% lidocaine penile block. Operation time, intra-operative blood loss, incision healing time, intra-operative and post-operative pain, the penile appearance and overall satisfaction degree were measured. Operation time and intra-operative blood loss were significantly lower in the Shang ring and suture device groups compared to the conventional group (P < 0.001). Intra-operative pain was less in the suture device group compared with the other two groups (P < 0.001); whereas post-operative pain was higher in the conventional group compared to the other two groups (P < 0.001). Patients in the suture device (80.57%) and Shang ring (73.57%) groups were more satisfied with penile appearances compared with the conventional circumcision group (20.06%, P < 0.05). Patients in suture device group also healed markedly faster than the conventional group (P < 0.01). The overall satisfaction rate was better in the suture device group (78.66%) compared with the conventional (47.13%) and Shang ring (50.00%) groups (P < 0.05). The combination of DCSD and lidocaine cream resulted in shorter operation and incision healing times, reduced intra-operative and post-operative pain and improved patient satisfaction with the cosmetic appearances.