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[[Image:Plastibell.jpg|right|thumb|A circumcision device that uses string to cut off blood flow to the foreskin, amputating it ]]
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.<ref name=Miller1953>{{REFjournal |last=Miller |first=R.L. |last2=Snyder |first2=D.C. |date=1953-01 |title=Immediate circumcision of the newborn male |journal=Am. J. Obstet. Gynecol. |volume=65 |issue=1 |pages=1-11 |url= |quote= |pubmedID=13016660 |accessdate=MillerSnyder1953}}</ref><ref name=Kariher1956>{{REFjournal
|last=Kariher
|firstinit=D.H.DH
|last2=Smith
|first2init2=T.W.TW
|date=1956-01
|title=Immediate circumcision of the newborn
==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 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.
==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%.<ref>{{REFjournal
|last=Izzidien Al-Samarrai
|firstinit=A.Y.AY
|last2=Mofti
|first2init2=A.
|last3=Crankson
|first3init3=S. J.SJ
|title=The Use of Plastibell in Neonatal Circumcision. Review of 2000 cases
|journal=Surg. Gyne & Obst.
}}</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>{{REFnews
|last=Brennae
|first=Mark
}}</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
|last=Ly
|firstinit=L.
|last2=Sankaran
|first2init2=K.
|date=2003
|title=Acute venous stasis and swelling of the lower abdomen and extremities in an infant after circumcision
|issue=3
|pages=216-7
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC167126/
|quote=
|pubmedID=12900483
|accessdate=2020-04-22}}</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=anaestheticMedical 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
|first=
}}</ref>
There also is a report of impetigo caused by ''Staphylococcus aureus '' when using the Plastibell.<ref>{{REFjournal
|last=Stranko
|firstinit=J. |first2=M.E.
|last2=Ryan
|first3init2=A.M.ME
|last3=Bowman
|init3=AM
|date=1986-09
|title=Impetigo in newborn infants associated with a plastic bell clamp circumcision
}}</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
|last=Bliss
|first=David P.
|init=DP
|last2=Healey
|first2=Patrick J.
|last2init2=HealeyPJ |last3=Waldhausen
|first3=John H.T.
|last3init3=WaldhausenJHT
|date=1997
|title=Necrotizing fasciitis after Plastibell circumcision
}}</ref><ref>{{REFjournal
|last=Woodside
|firstinit=J.R.JR
|date=1980-03
|title=Necrotizing fasciitis after neonatal circumcision
}}</ref>
There have been cases of [[necrosis ]] of the glans penis following [[circumcision ]] with the Plastibell device.<ref>{{REFjournal
|last=Bode
|firstinit=C.O. |first2=S.CO
|last2=Ikhisemojie
|first3init2=A.O.S
|last3=Ademuyiwa
|init3=AO
|date=2010
|title=Penile injuries from proximal migration of the Plastibell circumcision ring
== "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 installthe 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]]
== 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
}}
{{REF}}
[[Category:Circumcision productsproduct]]
[[Category:Financial gain]]