Difference between revisions of "Plastibell"
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==Advantages== | ==Advantages== | ||
| − | The [[glans]] is protected during the procedure by the ring. Hemostasis (control of bleeding) is effective due to the ligature tie. Cosmetically, a predictable result is obtained due to the straight line of the ligature that causes the wound. It is a quick procedure for the physician to perform — once mastered. | + | The [[glans]] is protected during the procedure by the ring. Hemostasis (control of [[bleeding]]) is effective due to the ligature tie. Cosmetically, a predictable result is obtained due to the straight line of the ligature that causes the wound. It is a quick procedure for the physician to perform — once mastered. |
| − | No bandage is required, allowing easy monitoring for infection. | + | No bandage is required, allowing easy monitoring for [[infection]]. |
| − | Healing occurs while the edges of the prepuce are secured in the ring, making [[skin bridge]]s (where the foreskin's end heals to the glans' corona) unlikely. | + | Healing occurs while the edges of the [[prepuce]] are secured in the ring, making [[skin bridge]]s (where the foreskin's end heals to the glans' corona) unlikely. |
| − | Cosmetically, there will be little to no [[circumcision scar]], though as usual with any circumcision, there will be a color change where the (formerly) inner and outer layers of foreskin meet. | + | Cosmetically, there will be little to no [[circumcision scar]], though as usual with any [[circumcision]], there will be a color change where the (formerly) inner and outer layers of [[foreskin]] meet. |
==Disadvantages== | ==Disadvantages== | ||
| − | The ring must fall off before final healing can occur. Rarely, the tip of the glans may protrude through the ring and become swollen, trapping the ring in place. Blood transfusion risk is 1 in 30,000 procedures (Wiswell). | + | The ring must fall off before final healing can occur. Rarely, the tip of the [[glans]] may protrude through the ring and become swollen, trapping the ring in place. Blood transfusion risk is 1 in 30,000 procedures (Wiswell). |
One study of 2000 Plastibell circumcisions found a complication rate of 1.8%.<ref>{{REFjournal | One study of 2000 Plastibell circumcisions found a complication rate of 1.8%.<ref>{{REFjournal | ||
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}}</ref> | }}</ref> | ||
| − | The foreskin must be slit and forced from the glans to allow entry for the plastic dome. | + | The [[foreskin]] must be slit and forced from the glans to allow entry for the plastic dome. |
| − | Furthermore, because convalescence depends on a (temporarily) affixed medical device, risks of infection or hemorrhage due to the bell slipping or otherwise failing are greater<ref>{{REFnews | + | Furthermore, because convalescence depends on a (temporarily) affixed medical device, risks of [[infection]] or [[bleeding| hemorrhage]] due to the bell slipping or otherwise failing are greater<ref>{{REFnews |
|last=Brennae | |last=Brennae | ||
|first=Mark | |first=Mark | ||
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}}</ref> than a [[Gomco|Gomco clamp]] or similar entirely-supervised circumcision. | }}</ref> than a [[Gomco|Gomco clamp]] or similar entirely-supervised circumcision. | ||
| − | There are several reports in the literature of urinary retention after circumcision with the Plastibell device.<ref>{{REFjournal | + | There are several reports in the literature of urinary retention after [[circumcision]] with the Plastibell device.<ref>{{REFjournal |
|last=Ly | |last=Ly | ||
|init=L | |init=L | ||
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|pubmedID=12900483 | |pubmedID=12900483 | ||
|accessdate=2020-04-22 | |accessdate=2020-04-22 | ||
| − | }}</ref> Death has been reported.<ref>[http://www.austlii.edu.au/cgi-bin/sinodisp/au/cases/vic/VCAT/2010/1772.html?stem=0&synonyms=0&query=anaesthetic Medical Board of Australia v Jabbar] (Occupational and Business Regulation) [2010] VCAT 1772 (5 November 2010)</ref><ref>{{REFjournal | + | }}</ref> [[Death]] has been reported.<ref>[http://www.austlii.edu.au/cgi-bin/sinodisp/au/cases/vic/VCAT/2010/1772.html?stem=0&synonyms=0&query=anaesthetic Medical Board of Australia v Jabbar] (Occupational and Business Regulation) [2010] VCAT 1772 (5 November 2010)</ref><ref>{{REFjournal |
|last=Paediatric Death Review Committee: Office of the Chief Coroner of Ontario | |last=Paediatric Death Review Committee: Office of the Chief Coroner of Ontario | ||
|first= | |first= | ||
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}}</ref> | }}</ref> | ||
| − | There have been multiple cases of children developing necrotizing fasciitis in their penis after being circumcised using the Plastibell device.<ref name=pubmed9329429>{{REFjournal | + | There have been multiple cases of children developing necrotizing fasciitis in their [[penis]] after being [[circumcised]] using the Plastibell device.<ref name=pubmed9329429>{{REFjournal |
|last=Bliss | |last=Bliss | ||
|first=David P. | |first=David P. | ||
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}}</ref> | }}</ref> | ||
| − | There have been cases of [[necrosis]] of the glans penis following circumcision with the Plastibell device.<ref>{{REFjournal | + | There have been cases of [[necrosis]] of the glans penis following [[circumcision]] with the Plastibell device.<ref>{{REFjournal |
|last=Bode | |last=Bode | ||
|init=CO | |init=CO | ||
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== "Non cutting"? == | == "Non cutting"? == | ||
| − | Plastibell is often described to parents as a non-cutting method. However, a dorsal slit (cut) is often performed at the beginning of the installation to make it easier to install. Once installed, the Plastibell cuts circulation to the foreskin, necrotizing the tissue, which will fall off in a few days (or it might be 'trimmed' after installing the Plastibell). The result is the same: the [[amputation]] of a healthy foreskin. | + | Plastibell is often described to parents as a non-cutting method. However, a [[dorsal slit]] (cut) is often performed at the beginning of the installation to make it easier to install the device. Once installed, the Plastibell cuts circulation to the [[foreskin]], necrotizing the tissue, which will fall off in a few days (or it might be 'trimmed' after installing the Plastibell). The result is the same: the [[amputation]] of a healthy [[foreskin]]. |
[[Image:Plastibelldrwg.jpg]] | [[Image:Plastibelldrwg.jpg]] | ||
| + | == Video == | ||
| + | <br> | ||
| + | * [https://med.stanford.edu/newborns/professional-education/circumcision/plastibell-technique.html Plastibell Technique] | ||
| + | {{SEEALSO}} | ||
| + | * [[Device displacement]] | ||
| + | * [[Dorsal penile nerve block]] | ||
| + | * [[Intraperitoneal bladder perforation]] | ||
| + | * [[Pain]] | ||
| + | * [[Trauma]] | ||
{{LINKS}} | {{LINKS}} | ||
* [http://www.thewholenetwork.org/14/post/2012/08/the-dangers-of-plastibell-circumcisions-graphic.html The Dangers of Plastibell Circumcisions - Graphic] | * [http://www.thewholenetwork.org/14/post/2012/08/the-dangers-of-plastibell-circumcisions-graphic.html The Dangers of Plastibell Circumcisions - Graphic] | ||
Latest revision as of 14:21, 26 December 2023
The Plastibell circumcision device is a clear plastic ring with a deep groove running circumferentially designed for circumcising infant males. It was invented by Hollister Inc in 1950, and first reported on in 1953.[1][2] The device works by providing a circumferencial surface upon which to tie off the foreskin.
Contents
Advantages
The glans is protected during the procedure by the ring. Hemostasis (control of bleeding) is effective due to the ligature tie. Cosmetically, a predictable result is obtained due to the straight line of the ligature that causes the wound. It is a quick procedure for the physician to perform — once mastered.
No bandage is required, allowing easy monitoring for infection.
Healing occurs while the edges of the prepuce are secured in the ring, making skin bridges (where the foreskin's end heals to the glans' corona) unlikely.
Cosmetically, there will be little to no circumcision scar, though as usual with any circumcision, there will be a color change where the (formerly) inner and outer layers of foreskin meet.
Disadvantages
The ring must fall off before final healing can occur. Rarely, the tip of the glans may protrude through the ring and become swollen, trapping the ring in place. Blood transfusion risk is 1 in 30,000 procedures (Wiswell).
One study of 2000 Plastibell circumcisions found a complication rate of 1.8%.[3]
The foreskin must be slit and forced from the glans to allow entry for the plastic dome.
Furthermore, because convalescence depends on a (temporarily) affixed medical device, risks of infection or hemorrhage due to the bell slipping or otherwise failing are greater[4] than a Gomco clamp or similar entirely-supervised circumcision.
There are several reports in the literature of urinary retention after circumcision with the Plastibell device.[5] Death has been reported.[6][7]
There also is a report of impetigo caused by Staphylococcus aureus when using the Plastibell.[8]
There have been multiple cases of children developing necrotizing fasciitis in their penis after being circumcised using the Plastibell device.[9][10]
There have been cases of necrosis of the glans penis following circumcision with the Plastibell device.[11]
"Non cutting"?
Plastibell is often described to parents as a non-cutting method. However, a dorsal slit (cut) is often performed at the beginning of the installation to make it easier to install the device. Once installed, the Plastibell cuts circulation to the foreskin, necrotizing the tissue, which will fall off in a few days (or it might be 'trimmed' after installing the Plastibell). The result is the same: the amputation of a healthy foreskin.
Video
See also
External links
- The Dangers of Plastibell Circumcisions - Graphic
Day, Danelle (2010). The Perils of Plastibell Circumcision: A Mythical "No Cutting, No Risk" Method
, Dr. Momma - peaceful parenting. Retrieved 24 September 2021.
References
- ↑
Miller RL, Snyder DC. Immediate circumcision of the newborn male. AJOG. January 1953; 6(1): 1-11. PMID. DOI. Retrieved 13 October 2021.
- ↑ Kariher DH, Smith TW. Immediate circumcision of the newborn. Obstet Gynecol. January 1956; 7(1): 50-3. PMID.
- ↑ Izzidien Al-Samarrai AY, Mofti A, Crankson SJ. The Use of Plastibell in Neonatal Circumcision. Review of 2000 cases. Surg. Gyne & Obst.. 1988; 167: 341-343.
- ↑
Brennae, Mark (13 June 2007)."Ontario boy dies after complications from circumcision", The Vancouver Sun: CanWest News Service. Retrieved 16 July 2008.
- ↑ Ly L, Sankaran K. Acute venous stasis and swelling of the lower abdomen and extremities in an infant after circumcision. CMAJ. 2003; 169(3): 216-7. PMID. Retrieved 22 April 2020.
- ↑ Medical Board of Australia v Jabbar (Occupational and Business Regulation) [2010] VCAT 1772 (5 November 2010)
- ↑ Paediatric Death Review Committee: Office of the Chief Coroner of Ontario. Circumcision: A minor procedure?. Paediatrics & child health. 2007; 12(4): 311-2. PMID. PMC. Retrieved 13 November 2019.
- ↑ Stranko J, Ryan ME, Bowman AM. Impetigo in newborn infants associated with a plastic bell clamp circumcision. Pediatric infectious disease. September 1986; 5(5): 597-9. PMID. Retrieved 13 November 2019.
- ↑ Bliss DP, Healey PJ, Waldhausen JHT. Necrotizing fasciitis after Plastibell circumcision. The Journal of Pediatrics. 1997; 131(3): 459-62. PMID. DOI. Retrieved 13 November 2019.
- ↑ Woodside JR. Necrotizing fasciitis after neonatal circumcision. American journal of diseases of children. March 1980; 134(3): 301-2. PMID. Retrieved 13 November 2019.
- ↑ Bode CO, Ikhisemojie S, Ademuyiwa AO. Penile injuries from proximal migration of the Plastibell circumcision ring. Journal of Pediatric Urology. 2010; 6(1): 23-7. PMID. DOI. Retrieved 13 November 2019.
