Tissue Glue Research Articles

The effect of fibrin sealant tissue glue in reducing post-operative collections following parotidectomy.

Seroma/sialocele and haematoma formations following parotidectomy are common complications. Fibrin-sealant tissue glue (FSTG) applied to the surgical bed prior to closure has been used widely to reduce such complications at other surgical sites. We sought to evaluate a potential role in parotidectomy, examining outcomes before and after the use of FSTG was introduced in our department. Outcomes were studied retrospectively for 1 year prior to the introduction of FSTG (group A, n = 31), and prospectively for 1 year subsequently (group B, n = 29). Primary outcome measures were seroma/sialocele and haematoma rates. Secondary outcome measures of interest included the use of a surgical drain and the duration of hospital stay. Chi-squared statistics and Mann-Whitney U tests were used to compare the outcomes between groups as appropriate. Seroma/sialocele rates were significantly lower in group B than in group A (n = 2 [6.9%] versus n = 8 [25.8%], p = 0.01) (Fig.1), with an absolute risk reduction of 18.9%, a relative risk reduction of 26.7%, and a number needed to treat of 5.3. Haematoma rates were similar between groups (n = 0 [0%] versus n = 1 [3.2%], p = 0.36) (Fig.2). In group A, a surgical drain was used in 24 cases (77.4%), while no cases in group B were drained.Fig. 1Seroma ratesFig. 2Haematoma rates CONCLUSION: The use of FSTG appears to significantly reduce the risk of post-parotidectomy seroma/sialocele formation and facilitates safe, drain-free daycase surgery. We hope this report will prompt other departments to consider using this technique and that our findings will help foster further appraisal in larger, prospective studies going forward.

Mortise and tenon–type elastic adhesive bandage for noninvasive closure of oozing wounds at areas of tension

Various wound closure techniques such as suturing, staples, tissue glue, or adhesive tapes are available. Adhesive surgical tape strips (Steri-Strips, 3M, St. Paul, MN) and tissue glue are not feasible for wounds with tension or oozing (Fig 1, A).1 Suturing and staples are invasive methods that demand additional cost and sometimes may leave cross-hatching marks.1

Role of in house tissue glue in tympanoplasty

Introduction: Tympanoplasty is one of the commonly performed surgical treatments for chronic otitis media (COM). Graft used in tympanoplasty is temporalis fascia which is placed at the perforation site but usually without any securing agent like sutures, etc., This can lead to various problems such as medialization or lateralization of the graft (graft displacement) or anterior blunting, which affects the hearing outcome of tympanoplasty. Aim: The aim of this study is to study the role of in house autologous tissue glue in tympanoplasty as a graft-securing agent. Materials and Methods: One hundred cases of COM were divided into two groups of fifty cases each. In Group I, tympanoplasty was done without using tissue glue, whereas in Group II, tympanoplasty was done using in house autologous tissue glue as the graft securing agent, and the results were analyzed. Results: Graft uptake rate in Group I was 84% and in Group II was 92%. Five cases of anterior blunting and three cases of graft medialization were recorded in Group I, whereas there was only one case of anterior blunting in Group II with no graft displacement. Conclusion: Autologous in house tissue glue can be used as a graft-securing agent in tympanoplasty.

Efficacy of Surgical Tissue Glues and Supporters for Treatment of Prolonged Air Leaks in Bullous Emphysema

To investigate the effect of collagen matrix tissue supporter made of bovine pericardium and polyethylene glycol (PEG) tissue glue on prolonged air leak and postoperative complications in patients with bullous emphysema. A retrospective study. Department of Thoracic Surgery, Health Sciences University, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey, from January 2010 to December 2018. A total of 60 patients (57 males, 3 females) with radiologically confirmed bullous emphysema, who underwent surgery for secondary spontaneous pneumothorax were reviewed, and grouped into three: Group 1 underwent endostapler/ peristrips (20 patients); Group 2 underwent endostapler / coseal (18 patients), and Group 3 underwent endostapler/ peristrips / coseal (22 patients). All groups underwent video-assisted thoracoscopic surgery. The groups were compared for complications, time for removal of chest tube, and duration of hospital stay. The groups were similar with respect to age and gender. The mean time to chest tube removal was 7.57 ±4.73 days (range; 3-21 days); the mean duration of hospital stay was 9.23 ±5.00 days (range; 4-23 days). Group 3 had the shortest time to chest tube removal and duration of hospital stay (5.82 ±2.87 and 7.36 ±3.04; p=0.010 and p=0.006). Significant inter-group difference originated between Group 2 and Group 3 (p=0.008 and p=0.005). Group 2 had the longest time to chest tube removal and duration of hospital stay (10.22 ±5.11 and 12.22 ±5.36). Group 3 had significantly a lower rate of prolonged air leak (9.1% n=1; p=0.021). Using coseal with a tissue supporter like Peristrips reduces postoperative complications, time to chest tube removal, and duration of hospital stay compared to its stand alone use.

Pterygium excision with conjunctival autograft fixed with sutures, glue, or autologous blood.

AIMS AND OBJECTIVES:This retrospective study compared surgical outcome of pterygium excision with conjunctival autograft fixed with sutures, tissue glue or autologous blood in relation to recurrence rate and surgical complications.MATERIALS AND METHODS:Surgical records of 148 patients operated for excision of primary nasal pterygium with conjunctival autograft were reviewed retrospectively for the period between January 2015 and June 2018. Based on surgical technique used to fix the graft, patients were divided into three groups. In Group A, 8 “0” vicryl suture was used to fix the graft in 90 patients. In Group B, fibrin glue was used to fix the graft in 23 patients. In Group C, autologous blood was used to fix the graft in 35 patients. Patients who were operated by single surgeon and had followed up for minimum six months were included in the study.RESULTS:Group A had recurrence in 7 cases (7.78%) whereas; Group B and C had no recurrence. But, in Group C two patients (5.71%) lost their graft. Overall recurrence rate in the study was 4.72%.CONCLUSION:Among the three techniques used in the study, recurrence was seen in the suture group and autologous blood group had loss of graft. The fibrin glue group was free of complications.

Supramolecular medical antibacterial tissue adhesive prepared based on natural small molecules.

In the field of biomedicine, tissue bio-adhesives require the use of polymer materials with integrated functions to meet changing practical applications. However, the currently available tissue glues cannot balance mechanical properties and biocompatibility. Inspired by the conversion of lipoic acid from small molecular biological sources into high-performance supramolecular polymeric materials, thioctic acid (TA) was modified and polyethylene glycol diacrylate (PEGDA) was introduced. Successfully constructed a dry gel with antibacterial effect and promote infection for wound regeneration. The prepared modified lipoic acid is mixed with PEGDA, melted under mild heating and self-assembled, and then directly extruded on both sides of the wound. It quickly cures at 37 °C and firmly adheres to both sides of the wound. The material exhibits good processability and rapid self-healing ability due to the cross-linked structure of the internal disulfide bonds and thioether bonds. In addition, the characteristics of TA make the prepared xerogels have good tissue adhesion and good antibacterial properties. This work proposes an innovative material with mechanical strength and biocompatible tissue glue, which provides broad prospects for application in wound treatment.

Intrapalpebral Extending Dysesthetic Bleb Revision with Fibrin Glue

ABSTRACTAimThis pilot study evaluates the safety and efficacy of a novel surgical technique using fibrin glue to treat bleb dysesthesia post-trabeculectomy due to intrapalpebral extension.BackgroundTrabeculectomy remains the gold standard for control of intraocular pressure (IOP) in refractory glaucoma. Bleb dysesthesia following antifibrotic-enhanced trabeculectomy is common, resulting in a significant decrease in quality of life. Symptoms include pain, foreign body sensation, and excessive tearing. Treatments include lubrication, topical nonsteroidal anti-inflammatory drugs (NSAIDs), bandage contact lens, bleb needling, compression sutures, Nd:YAG laser treatments, autologous blood injection, and cryopexy. These procedures can be time-consuming, risk bleb function, and may be ineffective at symptom control; thus, a novel technique is required.TechniqueThis is a retrospective case series of eyes undergoing bleb dissection with scleral cutdown and conjunctival closure with ARTISS fibrin tissue glue. Reported cases have been followed up for 6 months. Outcomes assessed include complications, IOP, medication usage, subjective pain score, visual field, and cup-to-disk (C:D) ratio.ConclusionThis small pilot series demonstrated that patients suffering from bleb dysesthesia due to intrapalpebral bleb extension can be successfully treated with a novel surgical approach combining conjunctival dissection to sclera with fibrin tissue glue closure. There was no significant effect on bleb function and no contribution to glaucoma progression over a 6-month period. A significant reduction in patient discomfort with no new surgical complications was noted.Clinical significanceThis demonstrates a safe and effective novel surgical approach to treat patients with this condition. The technique is easily learnt and can be employed in an outpatient setting. The technique is readily accepted by patients in group who are often reticent to undergo further intervention. Most importantly, it does not compromise bleb function or destabilize glaucoma control.How to cite this articleHolmes DP, Manning DK. Intrapalpebral Extending Dysesthetic Bleb Revision with Fibrin Glue. J Curr Glaucoma Pract 2020;14(1):37–42.

Mussel Adhesive Protein as a Promising Alternative to Fibrin for Scaffold Fixation during Cartilage Repair Surgery.

Fibrin has been used as a standard material for scaffold fixation during cartilage repair surgery. Most of the commercially available fibrin preparations need an additional method for scaffold fixation, most often with sutures, thus damaging the surrounding healthy cartilage. There is therefore a need to find alternatives to this method. In our study, we have investigated the potential possibility to use mussel adhesive protein as such an alternative. In this study, hydrophobic plastic was coated with the mussel adhesive protein Mefp-1 as well as with other cell adhesives (poly-lysine, fibronectin, and collagen). Human keratinocytes and chondrocytes were seeded on these substrates at 37°C in culture medium, followed by analysis of attachment and proliferation by crystal violet staining and metabolic labelling. Performance of Mefp-1 and fibrin as tissue glues were estimated by tensional force resistance measurement of moist porcine dermis (as a correlate to scaffold) glued to dermis, cartilage, or bone at 37°C. Mefp-1 supported maximal cell attachment at a coating density of approximately 1 µg/cm2. This was at least as good as the other adhesives tested. In addition, it supported cell proliferation at least as good as regular tissue culture plastic over a 7-day period. Measurement of tensional force resistance showed that Mefp-1 performed equally well as fibrin when porcine dermis was glued to cartilage and bone at the same concentration. Separation of the moist tissues after 15-minute incubation required a force of approximately 1 N/cm2 for both compounds. Mefp-1 show properties that qualify it as a compound that potentially could replace fibrin as a tissue glue for scaffold fixation. Given the possibilities to modify this protein by bioengineering, it is likely that the properties can be further improved.

Study on Closure of Skull Base Defect Post-Endoscopic Endonasal Transsphenoid Pituitary Surgery: A Novel Flap Design.

Objective This study was aimed to compare the closure of skull base defect in endoscopic endonasal transsphenoid surgery of pituitary tumors, using bipedicled nasal septal flap versus fascial closure. The study hypothesis being that bipedicled nasal septal flap is better, compared with fascial closure of skull base defect post-endoscopic endonasal transsphenoid surgery of pituitary tumors. Methods All the eligible patients were randomly divided into two groups and then randomly allocated to the surgeons. In one group, fat and fascia lata was used for closure of the skull base defect and nasal septal flap was not harvested whereas in the other, nasal septal flap was used for closure. Results There was a statistically significant difference in postoperative cerebrospinal fluid leak between the two groups. Patients who had undergone flap repair had lower incidence of postoperative cerebrospinal fluid (CSF) leak. Duration of postoperative hospital stay was also less among the group who underwent flap repair (statistically significant). Conclusion Bipedicled nasal septal flap serves an excellent cover for the skull base defect following endoscopic endonasal transsphenoidal pituitary surgery. It can prevent postoperative CSF leak even in cases where tissue glue is not used.

ARTISS (Fibrin Sealant Spray): Day-case Drain-less Mastectomy

Background: The use of drains in breast surgery is decreasing, and various methods of reducing the dead space after mastectomy in breast cancer have been described such as the quilting of skin flaps and the use of adhesive tissue glues. The British Association of Day Surgery (BADS) outlines a 30% day-case target for simple mastectomy procedures. We conducted a feasibility study using a fibrin sealant spray (ARTISS) instead of drains in mastectomy without reconstruction and prospectively audited the concomitant length of stay (LOS) & post-operative complications.

Does Sericin, as a Novel Pleurodesis Agent, Have Higher Effectiveness Compared to Talcum Powder, Doxycycline, and Silver Nitrate Pleurodesis?

IntroductionThe usefulness of sericin as pleurodesis agent has previously been described. Present study aims to compare sericin pleurodesis regarding success, effectiveness, tolerability, and side-effects. MethodsAdult, 12-week-old Wistar-albino rats (n=60), divided to five groups as sericin, talcum-powder, doxycycline, silver-nitrate and control. Agents were administrated through left thoracotomy, rats sacrificed twelve-days after. ResultsHighest ratio of collagen fibers was observed in sericin group, and the intensity was higher than talcum-powder group (p<0.05). Compared to silver nitrate, sericin group displayed better mesothelial reaction, and multi-layer mesothelium was also better (p<0.05). Foreign body reaction and emphysema were less frequent in sericin group (p<0.05). The presence of biological tissue in parenchyma was less prominent in sericin group (p<0.05). Foreign body reaction on thoracic wall was less common in sericin group (p<0.05). Presence of biological tissue glue in thoracic wall was less prominent in sericin group (p<0.05).Glomerular degeneration was lower in sericin group compared to the silver nitrate group (p<0.05), and tubular degeneration was less common in sericin group than talcum group (p<0.05). Pericarditis was less common in sericin group compared to the other groups (p<0.05). ConclusionAs an intrinsic, natural glue protein, sericin protects the lung parenchyma and tissues, and its glue-like characteristics enable pleurodesis. The success of sericin in pleurodesis was demonstrated in the present study based on investigations of the pleurae. Being cost-effective and better tolerated agent associated with a low potential of side effects, sericin is more effective, less expensive and provides more lung parenchyma protection.

Application of Histoacryl Tissue Glue in Breast Surgery

Objective to explore the effect of Histoacyl tissue glue (hereinafter referred to as tissue glue) on incision healing in breast surgery. Method review during October 2017 to October 2018, 500 cases of breast surgery to surgical treatment of cases, including 200 cases of tissue glue closed incision, 200 cases of absorbable suture material, 100 cases by traditional suture, comparing three sets of closing time of incision, postoperative hospital stay, complications, patients on art mouth closed satisfaction. Results: the three groups were superior to the absorbable suture material, group and the traditional suture group in the closing-length glue group with statistically significant differences (P<0.05). Postoperative hospitalization time in the glue group and the absorbable suture group was significantly better than that in the traditional suture group. Conclusion tissue glue is more ideal in reducing local inflammatory reaction, rejection reaction and higher patient satisfaction than the traditional non-absorbable suture of micro-sagebrush and traditional non-absorbable silk thread. The results of this clinical trial show the advantages of tissue glue in the incision suture of breast surgery.

Reducing seroma formation and its sequelae after mastectomy by closure of the dead space: The interim analysis of a multi-center, double-blind randomized controlled trial (SAM trial)

ObjectiveThe main objective of this double-blind randomized controlled trial (RCT) was to assess seroma formation and its sequelae in patients undergoing mastectomy. Patients were randomized into one of three groups in which different wound closure techniques were applied: 1) conventional wound closure without flap fixation (CON) 2) flap fixation using sutures (FF–S) and 3) flap fixation using an adhesive tissue glue (FF-G). BackgroundSeroma formation is still a bothersome complication after mastectomy. Flap fixation seems promising in reducing seroma formation. Various flap fixation techniques remain to be analyzed, including long-term outcome measures. MethodsThis trial was conducted in three different hospitals between June 2014 and November 2016. Patients were allocated to one of three groups. The primary outcome was the number of seroma needle aspirations. Secondary outcomes were (surgical site) infections, number of outpatient clinic visits, shoulder function, postoperative pain, patient-reported cosmesis and skin dimpling. ResultsA total of 187 patients were randomly assigned to CON (n = 61), FF-S (n = 64) and FF-G (n = 62). The number of seroma aspirations was significantly higher in CON when compared to both flap fixation groups (p = 0.032), with no difference between FF-S and FF-G. Secondary outcomes showed no statistical differences between all groups. The higher number of outpatient clinic visits in CON was considered to be of clinical importance (CON = 27 (44.3%), FF-S = 19 (30.6%) and FF-G = 21 (34.4%)). ConclusionsMastectomy followed by flap fixation with either sutures or adhesive tissue glue reduces the number of seroma aspirations when compared to simple wound closure.

Cyanoacrylate Glue Versus Suture Fixation of Mesh in Adult Inguinal Hernioplasty

Background: Tissue glues have been present for over twenty years and are used in surgery for a variety of indications. Use of N butyl- 2-cyanoacrylate based in inguinal hernia surgery were practiced for the first time in the mid-nineties. These non-suture techniques was aimed to decrease the chronic groin pain after hernioplasty without adversely affecting the outcomes Aim of the work: this study was designed to compare the operative outcomes of mesh fixation with glue versus that with suture. The primary objective was to compare pain in the immediate postoperative period and also to compare chronic postoperative pain. Patients and Methods: This prospective randomized study was performed Between January 2018 and January 2019 on 40 patients with unilateral inguinal hernia for whom open hernioplasty was done in the Department of surgery, Al-Azhar University Hospital, Damietta. Results: in the present study, there was significant difference in postoperative pain perception at 24 hours, at one week and at one month (p < 0.05) between glue group and suture group with lesser pain perception in the glue group. After the first month the difference between the two groups was non-significant. The mean operative time which was 44.35 min in the glue group and 57.33 min in suture group showed significant difference. As regard to the postoperative complications, the postoperative hematoma, infection and seroma were lesser in glue group but the difference was not significant. There was no recurrence in both groups. Conclusions: Cyanoacrylate glue for mesh fixation in Lichtenstein repair of adult inguinal hernia shows advantages over mesh fixation by sutures in terms of immediate and chronic post-operative pain, operative time, and postoperative complications.

Hot Glue Gun Releasing Biocompatible Tissue Adhesive

AbstractTissue bioadhesives are widely used in dermatology, surgery rooms, and in the field. Despite their advantages over sutures and staples, currently available tissue glues are limited by their mechanical properties and toxicity. Here, a new approach is described for wound closure that is based on a biocompatible, low melting point four‐armed N‐hydroxy succinimide‐modified polycaprolactone (star‐PCL‐NHS). Star‐PCL‐NHS is inserted into a hot melt glue gun, melts upon minimal pressure, and is extruded directly onto the wound, where it solidifies, bonding strongly with both edges of the wound. Changes in molecular weight allow control of adhesive strength, melting point, and elasticity properties. In vitro and in vivo evaluations confirm the biocompatibility of this system. The straightforward synthetic scheme and the simple delivery method, combined with the desirable mechanical properties, tunability, and tissue compatibility, are desirable traits in wound management.

Widespread clinical use of simethicone, insoluble lubricants, and tissue glue during endoscopy: A call to action for infection preventionists

Current methods for reprocessing flexible endoscopes do not consistently eliminate organic soil. The off-label use of simethicone as a defoaming agent may contribute to reprocessing failures, and endoscope manufacturers have cautioned against its use. We sought evidence of simethicone use by interviewing hospital personnel, conducting audits, inspecting endoscopes, and conducting tests. Researchers examined 69 fully reprocessed endoscopes in 4 hospitals. Microbial cultures were positive for ≥50% of endoscopes. Researchers observed cloudy, shimmery fluid resembling simethicone inside channels and under a duodenoscope elevator mechanism. Crystallized white fragments were observed protruding from a gastroscope water jet outlet. Oily, sticky residue was found on endoscopes, and a 3-dimensional mass was found inside an endoscopic ultrasound endoscope. Hospital personnel reported the use of simethicone, cooking oil and silicone sprays, and tissue glue during endoscopy. The off-label use of defoaming agents, lubricants, and tissue glue is common and many endoscopists consider these products essential. Our findings suggest these substances are not removed during reprocessing and may impact reprocessing effectiveness. Infection preventionists should determine whether these products are used in their institutions and evaluate methods for removing them. New policies may be needed to support procedural success and effective endoscope reprocessing.

A comparative study between conventional skin sutures, staples adhesive skin glue for surgical skin closure

Background: The signature of a surgeon is ‘scar’. Skin closure technique should be technically easy, acceptable, speedy and economical. Sutures and staples remain the mainstay of techniques. However, the use of GLUE is increasing in clinical practice. Authors compared all the three techniques in terms of time efficacy, post-operative pain, wound complications, cosmesis and cost-effectiveness.Methods: A 2-year prospective randomized controlled study was conducted on 90 healthy patients comparing tissue glue, staplers and sutures in primary wound closures following elective surgeries in the Department of General Surgery at BRAMC (October 2015 to October 2017).Results: The patients in the three groups were analyzed using chi-square, ANOVA, Fisher Exact test, and results were formulated. Staples consumed less time for application with a mean of 53.3 seconds when compared to glue (103.97 seconds) and sutures (294.97 seconds). Glue gave best results in terms of less post-operative pain. Mean VAS score calculated at 12,24,48,72 hrs was 63.13,42.10,16.94,7.27 and at 7 days was 4.73. The wound ASEPSIS score calculated on 3rd, 5th, and 7th day. Cosmesis score on 7th day, 1st month and 5th month was calculated using modified hollander and VAS cosmesis scale. Mean score with glue was 5.83,88.90 and 96.13 respectively. Cost of material including length of hospital stay for glue was also effective with 3.47 days on an average. All the above proved statistical significance.Conclusions: Staples application is faster, consumes less significant time than glue and sutures. Skin glue gives the best results in terms of less post-operative pain, wound asepsis, better cosmesis and cost-effectiveness. The concept of tissue glue is a safe, attractive, and effective alternate over other conventional methods of wound closures following elective surgeries.

Application of multi-slice spiral CT to assess vascular volume for the diagnosis and treatment of gastric varices

Objective: To differentiate the inflow and outflow channels of gastric varices in cirrhotic portal hypertension patients using multi-slice spiral CT (MSCT), and to assess the relationship between calculable CT volume of gastric varices and the amount of tissue adhesive. Methods: 97 cases with cirrhotic gastric varices who were admitted from November 2013 to August 2017 were selected. The type and shape of gastric varices were observed before tissue glue injection treatment by MSCT. The correlation between CT volume of gastric varices and the amount of tissue adhesive was evaluated by Spearman rank correlation coefficient and Univariate linear regression analysis. Results: MSCT showed that Le, g type had the highest proportion (54.6%), followed by Le, g, Lg (20.6%). Le, Lg and Lgf type accounted for 17.5%, and 5.2%, respectively, while Lgf+b accounted for 2.1%. On MSCT, varices of the gastric fundus were in the direction from bottom to top, and 75% of the fundus had a large curved side varices combined with gastric and renal shunt. Under the gastroscopy, varices in the small curved side of the gastric fundus from near to far were formless. In addition, varices in the large curved side of the gastric fundus when observed from different angles to the direction of blood flow (reverse gastroscope) were 72.7% (near and far) or 20.5 % (far and near). There was a positive correlation between CT volume (R = 0.97, P < 0.001) and the amount of tissue adhesive (Y(1) = 0.35 + 0.65X1, Univariate linear regression equation; ρ = 0.89, P < 0.001, Spearman correlation analysis). Conclusion: MSCT can recognize the vascular shape and inflow and outflow channels of gastric varices. A positive correlation between CT volume and the amount of tissue adhesive, suggested that the CT volume measurement before treatment could be used as one of the method to predict the amount of tissue adhesive.

Spontaneous intramural esophageal dissection preceded by intramural esophageal hematoma: Report of a case study

Spontaneous intramural esophageal dissection (IED) is a rare disorder characterized by acute symptoms, including chest pain, odynophagia, dysphagia, or hematemesis and remarkable endoscopic or radiographic findings. The pathophysiology is complex and remains poorly understood. Here, we report a 63‐year‐old woman who presented with progressive odynophagia, dysphagia, and weight loss. We diagnosed spontaneous IED with false lumen formation extending to the stomach using ultra‐thin upper endoscopy and water‐soluble contrast esophagogram. Comparing the patient's chronological computed tomographic images before and after symptom onset, we found that spontaneous IED was preceded by an intramural esophageal hematoma. Her symptoms persisted after 3 weeks of conservative treatment. Therefore, combined modalities of endoscopic transection and tissue glue application were given, and her symptoms improved gradually.

Useful Tips and Tricks for Secure Circumcision

Introduction: The study aimed to find a secure procedure for circumcision, using monopolar diathermy with several key steps of technique to facilitate the surgical process and minimize the postoperative complications. Methods: Patients who underwent the secure technique for circumcision, due to different reasons, from 2012 to 2016 were retrospectively reviewed. A monopolar coagulator with a needle point probe with energy ranging from 10 to 15 W was used to perform the circumcision by following several key steps. In addition, tissue glue was applied to the wound to provide operative wound care. All data referring to patient demographics were recorded. The outcomes and complications associated with the secure technique for circumcision were assessed. Discussion: One hundred and ten children underwent this technique, carried out by a senior teaching staff member and several senior residents. All patients were followed with a mean of 29.5 ± 30.1 days postoperatively. All these patients were satisfied with the operation and had no major complications, and no second revisions were needed during the follow-up period. Two patients (1.8%) had a minor wound infection, which was resolved with oral antibiotics within 1 week. However, the study limitations included its retrospective nature and the heterogeneity of the study population. Conclusion: Modified diathermy circumcision with the secure technique protects the penile phallus and urethra, and it is associated with a low rate of complications, as hemostasis can be simultaneously ensured. The technique is feasible, simple, and easy to learn. In addition, tissue glue was proved to facilitate postoperative wound care.