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S15: MISCELLANEOUS
Moderators: Chris Cooper (USA), Emilio Merlini (Italy)
ESPU Meeting on Friday 16, October 2015, 11:26 - 12:00
11:26 - 11:29
S15-1
(PP)
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QUALITY ASSURANCE PRACTICE FOR THE PLASTIBELL MALE NON-
THERAPEUTIC CIRCUMCISION IN INFANT UNDER 6 MONTHS IMPROVES THE
OUTCOME AT COMMUNITY CIRCUMCISION CLINIC
Abdul Rauf KHAN, Mohammed Ruhul AMIN and Murtaza KHANBHAI
Thornhill Circumcision Clinic, GP Clinic, Luton, UNITED KINGDOM
PURPOSE
Non-therapeutic infant male circumcision (IMC) is practised in the country by many clinics, religious venues and peoples’
home. There is no strict national policy for these providers. Our aim is to review the implementation of quality assurance
(QA) criteria under the supervision of trained paediatric surgeon for the outcome of the Plastibell IMC under 6 months of
age.
MATERIAL AND METHODS
We reviewed the outcome of 5661 Plastibell IMC’s under 6 months of age over a 4 year period (April 2007 to March
2011) in a community clinic under local anaesthesia. Data were collected retrospectively in first two years (group A) and
prospectively in next two years (group B). We compared before and after adaptation of 12 standards of QA modified for
IMC from WHO’s QA which includes the clinic settings, infection control, informed consent, training in performing IMC,
maintenance of competency, pain relief, postoperative management, follow up, audit of the complications,
safeguarding/resuscitation training, complaints process and registration with regulator of health and social care. Training
for doctors is held every 6 months under supervision of paediatric surgeon and clinical governance meeting held 4
monthly. Complications were compared between two groups.
RESULTS
Incidence of complications were significantly lower in group B (2.1% n=66/3095) versus group A (4.4% n=114/2566)
after implication of QA standards (p = 0.03). Post-operative bleeding (0.2% vs 0.6% n= 8 vs 16), clinical wound
infection (0.3% vs 0.4% n=9 vs 9), ring impaction/migration (0.8% vs 2.3% n= 24 vs 60) and redo circumcision (0.3%
vs 0.8% n= 8 vs 20) were significantly were lower in group B versus group A respectively (p <0.5). There is no
significant difference in complaints in these periods.
CONCLUSIONS
Application of strict criteria of QA has significantly improve the outcome of the non-therapeutic Plastibell IMC under 6
months at community circumcision clinic.