Annual audit has improved outcomes of circumcisions with disposable rings in children in a community clinic under local anaesthesia - Thornhill clinic and Leyton clinic, London

PURPOSE

To evaluate the early postoperative complications particularly impaction of disposable devices in children’s circumcision procedures under local anaesthesia in a community clinic in this year’s audit versus previous 3 audits. 

MATERIAL AND METHODS

In our current audit cycle, the outcome of circumcisions (n=1222) was prospectively studied over a 1-year period (May 2017 to April 2018) and were compared with the last 3 audit cycles. Circumcision was performed under local anaesthesia, by trained doctors in a community clinic using Circumplast (CC)(n=310) and Plastibell (PC)(n=912).  Early postoperative complications especially ring impaction were compared among the four audits. Follow-up was arranged if required.

RESULTS

The mean age was 4.4±0.3 months (median 1.5). Complication rate in this year’s audit was 5.1%(62/1222). There is no significant difference in overall complications rate in CC(6.8%n=21/310) versus PC(4.5%n=64/979)(p>0.5). Delayed ring separation/impaction is significantly lower in CC (1% n=3/310) versus PC (2.4% n=22/912) (p<0.05) and has significantly improved from the previous three audits. In current year, 202 (16.5%) children were followed and mean duration was 10±2.6 days (median 6).

CONCLUSIONS

The annually conducted audit has shown improved outcomes of circumcisions with disposable rings in children in a community clinic under local anaesthesia over successive years.

Ref: Accepted as presentation and poster in ESPU 30th Meeting, Lyon, France.