Muhammad Danish Muneeb, Mirza Agha Naushad Baig.
Proper Technique Prevents Poor Performance and Fate: a Comparison of Circumcision By Plastibell Method in Neonates and Infants.
J Dow Uni Health Sci Jan ;13(1):37-42.

Objective: To evaluate the effectiveness of circumcision performed by Plastibell method by virtue of its complications among neonates and infants.  Methods: A prospective study was conducted at Baqai University Hospital Karachi during the period of January 2016 to January 2018. Plastibell circumcision was performed in 300 neonates and infants. A standard proforma was employed regarding patient's age, size of the ring, time taken for the device to fallnd off, and complications. All neonates and infants were called on 2 day and were advised to inform the day of the ring to slough off. Results: Of 300 cases, 274 (91.3%) patients were complication free. Amongst these, 10/150 (93.3%) were neonates and 134/150 (89.3%) were infants. The overall complications were in 26 (8.7%) cases which included delayed separation of Plastibell ring in 11 (42.3%), proximal ring migration in 7 (26.9%) cases, bleeding in 5 (19.2%), and localized supericial infection in 3 (11.5%) cases. A signiicant difference of ring slough was observed among neonates and infants (p value < 0.001). However, the complications developed were not affected either by ring size (p-value 0.135) or ring slough off time (p-value 0.977). Conclusion: The difference of rate of complications between neonates and infants is minimal. Therefore, the age difference of neonates and infants does not pardon Plastibell technique and renders it safe and similar in its outcome till one year of age. Hence, a proper Plastibell circumcision technique provides satisfactory results even in a year-old child and rectiies the hesitancy among surgeons. 

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com