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>{{MillerSnyder1953REFjournal | last=Miller | first=RL | coauthors=Snyder DC | pubyear=1953, January | title=Immediate circumcision of the newborn male | journal=Am. J. Obstet. Gynecol. | volume=65 | issue=1 | pages=1-11 | url= | quote= | pubmedID=13016660 | accessdate=}}</ref><ref name=Kariher1956>{{REFjournal |last=Kariher |initfirst=DH |last2coauthors=Smith |init2=TW |datepubyear=1956-01, January |title=Immediate circumcision of the newborn |journal=Obstet Gynecol |volume=7 |issue=1 |pages=50-3 |url= |quote= |pubmedID=13280246 |accessdate=}}</ref> The device works by bo 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 bridge]]s 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.

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 |init=AY |last2=A.Y., Mofti |init2=A |last3=. Crankson |init3=SJ |title=S. J 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=1988November 2012}}--></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 | coauthors= |url=http://www.canada.com/vancouversun/story.html?id=cb3b8281-4134-46ba-85d3-b076072bda75&k=25810 |title=Ontario boy dies after complications from circumcision |date=June 13, 2007-06-13 |publisher=The Vancouver Sun: CanWest News Service |quote= |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>{{REFjournal |last=Ly |initfirst=L |last2coauthors=Sankaran |init2=K |datepubyear=2003 |title=Acute venous stasis and swelling of the lower abdomen and extremities in an infant after circumcision |journal=CMAJ |volume=169 |issue=3 |pages=216-7 |url=https://www.ncbicmaj.nlm.nih.govca/pmccontent/articles169/PMC1671263/216.long |quote= |pubmedID=12900483 |accessdate=20202025-04-2223}}</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 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 |first= |datecoauthors= | pubyear=2007 |title=Circumcision: A minor procedure? |journal=Paediatrics & child health |volume=12 |issue=4 |pages=311-2 |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2528673/ |quote= |pubmedID=19030377 |pubmedCID=2528673 |accessdate=2019-11-13

There also is a report of impetigo caused by ''Staphylococcus aureus'' when using the Plastibell.<ref>{{REFjournal |last=Stranko |initfirst=Jj |last2coauthors=ME Ryan |init2=ME |last3=, AM Bowman |init3=AM |datepubyear=1986-09 |title=Impetigo in newborn infants associated with a plastic bell clamp circumcision |journal=Pediatric infectious disease |volume=5 |issue=5 |pages=597-9 |url=http://www.cirp.org/library/complications/stranko1/ |quote= |pubmedID=3763425 |accessdate=2019-11-13

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 |first2coauthors=Patrick J. |init2=PJ |last3=Waldhausen |first3=Healey, John H.T.Waldhausen |init3=JHT |datepubyear=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 |DOI=10.1016/S0022-3476(97)80078-9 |pubmedID=9329429

|last=Woodside |initfirst=JR |datecoauthors= | pubyear=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.cirp.org/library/complications/woodside2/ |quote= |pubmedID=6444778 |accessdate=2019-11-13

There have been cases of [[necrosis]] of the glans penis following [[circumcision]] with the Plastibell device.<ref>{{REFjournal |last=Bode |initfirst=COC.O. |last2coauthors=S. Ikhisemojie |init2=S |last3=, A.O. Ademuyiwa |init3=AO |datepubyear=2010 |title=Penile injuries from proximal migration of the Plastibell circumcision ring |journal=Journal of Pediatric Urology |volume=6 |issue=1 |pages=23-7 |url=https://www.researchgate.net/publication/256010137_Management_of_Plastibell_circumcision_ring_migration_and_glans_penis_incarceration |quote= |pubmedID=19570722 |DOI=10.1016/j.jpurol.2009.05.011 |accessdate=2019-11-13

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 install the 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]].

* {{REFweb |url=[http://www.drmommathewholenetwork.org/201014/post/2012/0508/the-perilsdangers-of-plastibell-circumcisioncircumcisions-graphic.html |title=The Perils Dangers of Plastibell Circumcision: A Mythical "No Cutting, No Risk" Method |last=Day |first=Danelle |website=[[Dr. Momma PlastiBell Circumcisions - peaceful parentingGraphic]] |date=2010 |accessdate=2021-09-24}}

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