Using a foreskin holder and surgical pen mark for improved tissue alignment prior to early infant male circumcision
Brown University, Department of Family Medicine, Providence, United States
Background: In a comprehensive review of the complications of circumcision Kaplan noted that errors made in removing insufficient or excess amounts of foreskin during infant male circumcision could be prevented by marking the site of the corona on the skin surface prior to making an incision.
Methods: We have developed a foreskin holder that can be used in conjunction with a surgical pen mark to help providers align the foreskin during male circumcision. The foreskin holder is removable, inexpensive, disposable, and can be adapted to any device that uses a glandular shield. In an institutional review board approved prospective, observational study we evaluated this foreskin holder in 150 patients.
Results: Patients ranged in age from 1 day to 3 months (mean 8 days) and in penile shaft diameter measured at the coronal margin from 1.1 cm to 1.6 cm (mean 1.3 cm). In all 150 patients the foreskin holder was able to accurately retain and align the foreskin on the shielding surface. The surgical pen mark made on the foreskin was accurately aligned on the shielding ring in each case.
Conclusions: We have demonstrated that this foreskin holder can retain and align the foreskin on a shielding surface prior to infant male circumcision.
[Figure 1: Self adjusting foreskin holder.]
[Figure 2: Using a pen mark and foreskin holder.]
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