16 research outputs found

    Adult circumcision in the prevention of HIV/AIDS

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    Rapid, minimally invasive adult voluntary male circumcision: A randomised trial of Unicirc, a novel disposable device

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    Background. Voluntary medical male circumcision (VMMC) is a priority HIV preventive intervention. To facilitate VMMC scale-up, the World Health Organization is seeking circumcision techniques that are faster, easier, and safer than open surgical methods.Objective. To compare open surgical circumcision with suturing v. the Unicirc disposable instrument plus tissue adhesive.Methods. We conducted a non-blinded randomised controlled trial at an outpatient primary healthcare clinic in Cape Town, South Africa, with 2:1 allocation ratio of 150 male volunteers who were at least 18 years of age. Our primary outcome was intraoperative time and secondary outcomes were ease of performance, post-operative pain, adverse events, time to healing, patient satisfaction and cosmetic result. Results. The intraoperative time was less with the Unicirc/adhesive technique (median 13 v. 22.6 min, respectively; p<0.001). The intraoperative suturing rate was 17% using the Unicirc device. Other adverse events and wound healing outcomes were similar in both groups, but the cosmetic result was superior in the Unicirc group. Doctors found the Unicirc procedure easier to perform and preferred it to the open surgical technique. Conclusions. This study has important implications for the scale-up of VMMC services. Excising the foreskin with the Unicirc instrument and sealing the wound with cyanoacrylate tissue adhesive in adults is quicker, easier to learn, and is potentially safer than open surgical VMMC. Further studies should be conducted with the optimised device. This new instrument has the potential to facilitate more rapid scale-up and save costs.

    Success brings new challenges in circumcision campaign

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    Rapid, minimally invasive adult voluntary male circumcision : a randomised trial of Unicirc, a novel disposable device

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    CITATION: Millard, P. S., Wilson, H. R., Goldstuck, N. D. & Anaso, C. 2014. Rapid, minimally invasive adult voluntary male circumcision: a randomised trial of Unicirc, a novel disposable device. South African Medical Journal, 104(1):52-57, doi:10.7196/SAMJ.7357.The original publication is available at http://www.samj.org.zaBackground. Voluntary medical male circumcision (VMMC) is a priority HIV preventive intervention. To facilitate VMMC scale-up, the World Health Organization is seeking circumcision techniques that are faster, easier, and safer than open surgical methods. Objective. To compare open surgical circumcision with suturing v. the Unicirc disposable instrument plus tissue adhesive. Methods. We conducted a non-blinded randomised controlled trial at an outpatient primary healthcare clinic in Cape Town, South Africa, with 2:1 allocation ratio of 150 male volunteers who were at least 18 years of age. Our primary outcome was intraoperative time and secondary outcomes were ease of performance, post-operative pain, adverse events, time to healing, patient satisfaction and cosmetic result. Results. The intraoperative time was less with the Unicirc/adhesive technique (median 13 v. 22.6 min, respectively; p<0.001). The intraoperative suturing rate was 17% using the Unicirc device. Other adverse events and wound healing outcomes were similar in both groups, but the cosmetic result was superior in the Unicirc group. Doctors found the Unicirc procedure easier to perform and preferred it to the open surgical technique. Conclusions. This study has important implications for the scale-up of VMMC services. Excising the foreskin with the Unicirc instrument and sealing the wound with cyanoacrylate tissue adhesive in adults is quicker, easier to learn, and is potentially safer than open surgical VMMC. Further studies should be conducted with the optimised device. This new instrument has the potential to facilitate more rapid scale-up and save costs.http://www.samj.org.za/index.php/samj/article/view/7357Publisher's versio

    Sutureless adult voluntary male circumcision with topical anesthetic: a randomized field trial of Unicirc, a single-use surgical instrument

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    Introduction The World Health Organization has solicited rapid and minimally invasive techniques to facilitate scale-up of voluntary medical male circumcision (VMMC). Study design Non-blinded randomized controlled field trial with 2:1 allocation ratio. Participants 75 adult male volunteers. Setting Outpatient primary care clinic. Intervention Open surgical circumcision under local anesthetic with suturing vs. Unicirc disposable instrument under topical anesthetic and wound sealing with cyanoacrylate tissue adhesive. Primary Outcome Intraoperative duration. Secondary Outcomes Intraoperative and postoperative pain; adverse events; time to healing; patient satisfaction; cosmetic result. RESULTS: The intraoperative time was less with the Unicirc technique (median 12 vs. 25 min, p < 0.001). Wound healing and cosmetic results were superior in the Unicirc group. Adverse events were similar in both groups. CONCLUSIONS: VMMC with Unicirc under topical anesthetic and wound sealing with cyanoacrylate tissue adhesive is rapid, heals by primary intention with superior cosmetic results, and is potentially safer and more cost-effective than open surgical VMMC. Trial Registration Clinicaltrials.gov NCT0244379

    Circumcision Clamps for Adults

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    Circumcision is one of the surgical interventions with the longest historical tradition for various medical or non-medical, religious and social, reasons. Due to a high demand for this surgery, in recent years, a large number of plastic and disposable devices have emerged in order to optimize the technique. Although they were initially used in newborns and children, their use in recent years has been expanding to adults. The main objectives of these devices are to shorten the surgical time, simplify the technique, and maintain an adequate safety profile compared to the classic suture technique. All reviewed devices for adult circumcision appear to achieve these goals, making them a safe, fast, and feasible option for use in an outpatient setting or in high-demand areas

    Success brings new challenges in circumcision campaign

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