Changes

The '''Plastibell Circumcision Device ''' 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.<ref name=Miller1953>{{cite journal|authorMillerSnyder1953}}</ref><ref name=Miller RL, SnyderKariher1956>{{REFjournal | title last= Immediate circumcision of the newborn maleKariher | journal init= Am. J. Obstet. Gynecol.DH | volume last2= 65Smith | issue init2= 1TW | pages date= 1–11 | year = 1953 | month = January | pmid = 13016660 | last2 = Snyder | first2 = DC}}</ref><ref name=Kariher1956>{{cite journal|author = Kariher DH, Smith TW1956-01 |title = Immediate circumcision of the newborn |journal = Obstet Gynecol |volume = 7 |issue = 1 |pages = 50–350-3 |year url= 1956 |month quote= January |pmid pubmedID= 13280246 |accessdate=}}</ref> The device works bo by providing a circumferencial surface upon which to tie off the [[foreskin]].

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 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 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.

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 |last=Izzidien Al-Samarrai A.Y., |init=AY |last2=Mofti |init2=A. |last3=Crankson S. J |init3=SJ |title=The Use of Plastibell in Neonatal Circumcision. Review of 2000 cases. |journal=Surg. Gyne & Obst. |volume=167: |pages=341-343, 1988{{vs|couldn't find |date=November 20121988}}</ref>

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 [[bleeding| hemorrhage ]] due to the bell slipping or otherwise failing are greater<ref>{{cite news | first = MarkREFnews | last = Brennae | title first= Ontario boy dies after complications from circumcisionMark | url = http://www.canada.com/vancouversun/story.html?id=cb3b8281-4134-46ba-85d3-b076072bda75&k=25810 |title=Ontario boy dies after complications from circumcision | work date= The Vancouver Sun2007-06-13 | publisher = The Vancouver Sun: CanWest News Service | date quote= June 13, 2007 | accessdate = 2008-07-16}}</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>{{cite journal |pmid=12900483 |year=2003 |last1=Ly |first1=L |last2=Sankaran |first2=K |title=Acute venous stasis and swelling of the lower abdomen and extremities in an infant after circumcision |volume=169 |issue=3 |pages=216–7 |pmc=167126 |journal=CMAJ}}</ref> Death has been reported.<ref>[http://www.pulsus.com/Paeds/12_04/Pdf/zwol_ed.pdf Paediatrics & Child Health, Home<!-- Bot generated title -->]</ref><ref>http://www.austlii.edu.au/cgi-bin/sinodisp/au/cases/vic/VCAT/2010/1772.html?stem=0&synonyms=0&query=anaesthetic{{full|date=November 2012}}</ref><ref>{{cite journal |pmid=19030377 |year=2007 |author1=Paediatric Death Review Committee: Office of the Chief Coroner of Ontario |title=Circumcision: A minor procedure? |volume=12 |issue=4 |pages=311–2 |pmc=2528673 |journal=Paediatrics & child health}}</ref>

There also is a report are several reports in the literature of impetigo caused by Staphylococcus aureus when using urinary retention after [[circumcision]] with the Plastibelldevice.<ref>{{cite REFjournal |last=Ly |init=L |last2=Sankaran |init2=K |date=2003 |title=Acute venous stasis and swelling of the lower abdomen and extremities in an infant after circumcision |journal =CMAJ |pmidvolume=3763425 169 |yearissue=1986 3 |last1pages=Stranko 216-7 |first1url=J https://www.ncbi.nlm.nih.gov/pmc/articles/PMC167126/ |last2quote= |pubmedID=12900483 |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=Ryan anaesthetic Medical Board of Australia v Jabbar] (Occupational and Business Regulation) [2010] VCAT 1772 (5 November 2010)</ref><ref>{{REFjournal |first2last=ME Paediatric Death Review Committee: Office of the Chief Coroner of Ontario |last3first=Bowman |first3date=AM 2007 |title=Impetigo in newborn infants associated with a plastic bell clamp circumcision Circumcision: A minor procedure? |journal=Paediatrics & child health |volume=5 12 |issue=5 4 |pages=597–9 311-2 |journalurl=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2528673/ |quote= |pubmedID=19030377 |pubmedCID=2528673 |accessdate=Pediatric infectious disease2019-11-13}}</ref>

There have been multiple cases also is a report of children developing necrotizing fasciitis in their penis after being circumcised impetigo caused by ''Staphylococcus aureus'' when using the Plastibell device.<ref name=pubmed9329429>{{cite journal REFjournal |doilast=10.1016/S0022-3476(97)80078-9 Stranko |titleinit=Necrotizing fasciitis after Plastibell circumcision J |yearlast2=1997 Ryan |last1init2=Bliss ME |first1last3=David P. Bowman |last2init3=Healey AM |first2date=Patrick J. 1986-09 |last3title=Waldhausen |first3=John H.T. Impetigo in newborn infants associated with a plastic bell clamp circumcision |journal=The Journal of Pediatrics Pediatric infectious disease |volume=131 5 |issue=3 5 |pages=459–62 597-9 |pmidurl=9329429}}<http://www.cirp.org/library/complications/stranko1/ref><ref>{{cite journal |pmidquote=6444778 |yearpubmedID=1980 3763425 |last1accessdate=Woodside |first1=JR |title=Necrotizing fasciitis after neonatal circumcision |volume=134 |issue=3 |pages=301–2 |journal=American journal of diseases of children2019-11-13}}</ref>

There have been multiple cases of necrosis of the glans children developing necrotizing fasciitis in their [[penis following circumcision with ]] after being [[circumcised]] using the Plastibell device.<refname=pubmed9329429>{{cite REFjournal |last=Bliss |first=David P. |init=DP |last2=Healey |first2=Patrick J. |init2=PJ |last3=Waldhausen |first3=John H.T. |init3=JHT |date=1997 |title=Necrotizing fasciitis after Plastibell circumcision |journal =The Journal of Pediatrics |volume=131 |issue=3 |pages=459-62 |url=http://www.cirp.org/library/complications/bliss/ |quote= |accessdate=2019-11-13 |doiDOI=10.1016/jS0022-3476(97)80078-9 |pubmedID=9329429}}</ref><ref>{{REFjournal |last=Woodside |init=JR |date=1980-03 |title=Necrotizing fasciitis after neonatal circumcision |journal=American journal of diseases of children |volume=134 |issue=3 |pages=301-2 |url=http://www.jpurolcirp.2009.05.011 org/library/complications/woodside2/ |quote= |pubmedID=6444778 |titleaccessdate=Penile injuries from proximal migration 2019-11-13}}</ref> There have been cases of [[necrosis]] of the glans penis following [[circumcision]] with the Plastibell circumcision ring |year=2010 device.<ref>{{REFjournal |last1last=Bode |first1init=C.O. CO |last2=Ikhisemojie |first2init2=S. |last3=Ademuyiwa |init3=AO |first3date=2010 |title=A.O. Penile injuries from proximal migration of the Plastibell circumcision ring |journal=Journal of Pediatric Urology |volume=6 |issue=1 |pages=23–7 23-7 |url=https://www.researchgate.net/publication/256010137_Management_of_Plastibell_circumcision_ring_migration_and_glans_penis_incarceration |pmidquote= |pubmedID=19570722 |DOI=10.1016/j.jpurol.2009.05.011 |issueaccessdate=12019-11-13}}</ref>

PlastiBell 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 installthe device. Once installed, the PlastiBell 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 PlastiBellPlastibell). The result is the same: the [[amputation ]] of a healthy [[foreskin]].

== External Links 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}}* [http://www.thewholenetwork.org/14/post/2012/08/the-dangers-of-plastibell-circumcisions-graphic.html The Dangers of Plastibell Circumcisions - Graphic]* {{REFweb |url=http://www.drmomma.org/2010/05/the-perils-of-plastibell-circumcision.html |title=The Perils of Plastibell Circumcision: A Mythical "No Cutting, No Risk" Method |last=Day |first=Danelle |website=[[Dr. Momma - peaceful parenting]] |date=2010 |accessdate=2021-09-24}}

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