Outcome Analysis of Continuous Versus Interrupted Sutures for Adult Circumcision at a Tertiary Care Centre, Tamil Nadu, India

Introduction: Circumcision is the most common reconstructive urological procedure all over the world with minimal complications. It comprises of surgical removal of the prepuceal skin from the penis. Bleeding and infection are the major complications associated with traditional interrupted sutured circumcision. Hence continuous suturing techniques were explored to replace the traditional interrupted absorbable sutures. Aim: To compare the outcome of continuous and interrupted absorbable suturing techniques for adult circumcision. Materials and Methods: This retrospective study was conducted at PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India, in 250 adult patients undergoing circumcision between January 2018 and December 2020 in a Tertiary Care Hospital in Southern India. Among the 250 adult patients, 125 patients underwent circumcision with continuous absorbable suturing techniques (group I) and 125 patients with interrupted absorbable suturing technique (group II). Comparative outcome analysis of both the groups was done based upon the following parametersbleeding, infection, surgical wound dehiscence, swelling in the phallus, Visual Analog Score (VAS) for pain assessment, readmission to the hospital, and cosmesis. The comparison of quantitative variables between the groups was done using chi-square test. Results: In total, 250 adult patients were included in this study. The age was 44.3±14.3 years in continuous suture and 43.4±13.6 years in interrupted suture group. Balanitis with phimosis was the commonest indication for adult circumcision. The mean time taken for circumcision in group I and II was 14 minutes and 45 minutes, respectively. The average healing period was six days in group I and 13 days in group II. No major urological complications were observed in both the groups which might have required re admission. But fewer postoperative complications were encountered in group I with respect to wound infection (p-value=0.0002) and suture granuloma (p-value=0.02). Conclusion: The present study demonstrated better postoperative outcomes, reduced surgical time, reduced suture material requirement, and better cosmesis in adult circumcision using continuous absorbable suturing technique compared to the traditional interrupted techniqu