Department of Surgery, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
Department of Surgery, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
J Pediatr Urol. 2019 Oct;15(5):562.e1-562.e5. doi: 10.1016/j.jpurol.2019.07.015. Epub 2019 Jul 26.
Plastibell is one of the most common disposable devices used for circumcision. The study aims to determine whether changing the thread type from cotton to polypropylene to tie around the Plastibell in neonatal circumcision would result in faster separation of the ring.
Prospective, randomized, clinical and biomechanical studies were performed. All circumcisions were performed by a single surgeon. Data collected included anthropometric measures, demographic data, procedure time, complications, parent satisfaction, follow-up, and outcomes. The biomechanical study measured the tensile properties of both threads using a universal testing machine (4465; Instron, Norwood, MA).
Two hundred full-term, male neonates aged between 24 and 48 h were circumcised using Plastibell. Both groups were similar in gestational age, age at circumcision, body weight, height, head circumference, Apgar score at 1 and 5 min, procedure time, Plastibell size, and parent satisfaction. The subjects were randomized into two groups of 100 neonates each: group I where Plastibell was tied by a cotton thread supplied by the manufacturer and group II where Plastibell was tied by Polypropylene 0. The mean duration for Plastibell fall-off was 8.98 days and 7.74 days in cotton thread and Polypropylene 0, respectively (P-value < 0.001). There was no difference regarding the complications for both groups. The diameters of the cotton and Polypropylene 0 threads were 0.68 mm and 0.35 mm, respectively. The measured tensile strengths of cotton and Polypropylene thread were 180 MPa and 457 MPa, respectively.
Plastibell tied by Polypropylene 0 fell off faster than that tied by cotton thread, with no significant differences in adverse effects or complications. This finding might be relevant for anxious parents and caregivers. Further studies are needed to examine other types and sizes of threads to investigate whether this separation period can be reduced further.
Plastibell 是最常用的一次性包皮环切术器械之一。本研究旨在确定在新生儿包皮环切术中，将用于结扎 Plastibell 的缝线由棉线改为聚丙烯线是否会导致环更快地分离。
进行了前瞻性、随机、临床和生物力学研究。所有包皮环切术均由一名外科医生完成。收集的数据包括人体测量学指标、人口统计学数据、手术时间、并发症、家长满意度、随访和结果。生物力学研究使用万能试验机（4465；Instron，Norwood，MA）测量两种缝线的拉伸性能。
200 例胎龄 24-48 小时的足月男性新生儿使用 Plastibell 进行了包皮环切术。两组的胎龄、包皮环切术时的年龄、体重、身高、头围、1 分钟和 5 分钟时的 Apgar 评分、手术时间、Plastibell 大小和家长满意度均相似。将受试者随机分为两组，每组 100 例：I 组使用制造商提供的棉线结扎 Plastibell，II 组使用聚丙稀 0 结扎 Plastibell。Plastibell 脱落的平均时间分别为棉线组 8.98 天和聚丙稀 0 组 7.74 天（P 值<0.001）。两组并发症无差异。棉线和聚丙稀 0 线的直径分别为 0.68mm 和 0.35mm。棉线和聚丙稀线的拉伸强度分别为 180MPa 和 457MPa。
聚丙稀 0 结扎的 Plastibell 脱落速度快于棉线结扎，不良影响或并发症无显著差异。这一发现可能与焦虑的家长和护理人员有关。需要进一步研究其他类型和尺寸的缝线，以探讨是否可以进一步缩短分离期。
