Muhammad Sajjad Ashraf, Muhammad Shahab Athar, Naeem Ahmed, Yasir Arafat Gabol, Muhammad Talat Mehmood.
Complications of circumcision with Plastibel: are they age related?.
Pak J Surg Jan ;26(1):41-5.

Objective: To fi nd out the relationship of complications of Plastibel circumcision with age of the child. Study Design: Comparative descriptive study. Sett ing & Duration: Department of pediatric surgery Civil Hospital Karachi, Zubaida Medical Centre, Al-Khidmat Hospital, Shah Faisal Colony & Usman Memorial Hospital. From April 2005 to Jan 2009 (3 years & 10 months). Methodology: 906 children undergoing circumcision with Plastibel were studied. Th eir age, place of procedure, size of Plastibel used, duration for spontaneous separation of Plastibel, early and late complications were recorded on a proforma. Post operative follow up was carried out on 7th day, 14th day and aft er 3 months. Aft er collecting the data cases were divided into 3 groups, Group A under 2 years of age, Group B 2 to 5 years of age & Group C more than 5 years of age. Finally time of separation of Plastibel, early and late complications in these groups was compared. Results: Th eir age varies from 1 day to 11 years. In most cases, circumcision was performed as an isolated procedure in Operation Th eater under local anesthesia. We found that in group A 11.5 % cases had their Plastibel shed off within 5 days which was not seen in any other group. In Group A 55.9 % children had their Plastibel shed off within 7 days. In group B most (55.3 %) children have their Plastibel shed off between 8th to 10th day and in group C most (34.3 %) children have their Plastibel shed off aft er 10 days and larger proportion (31.3 %) needs removal. In Group A only 4.9 % children had early complications, while in Group B early complications were 7.9 % and in Group C 41.7 %. Similarly late complications were also more common in group C (4.4 %) while in Group B it was 1.07 % and in Group A it was 1.8 %. Conclusion: We concluded that Complications of circumcision with Plastibel are related to the age of the child as the age advances the rate of complications increases. Th ere is a high incidence of both early and late complications of circumcision with Plastibel in children above 5 years of age & Circumcision with Plastibel is best for children under 2 years of age.

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