Examination of histopathological changes of scalpel, monopolar, bipolar, and thermocautery applications in rat experimental circumcision model

This study endeavors to analyze the effects of thermocautery, bipolar cautery, monopolar cautery, and the scalpel to show that the thermocautery is a safe device to be used in circumcision. Twenty-four rats were assigned to 4 different groups: the scalpel, thermocautery, bipolar cautery, and monopolar cautery groups. Circumcisions were performed using the scalpel, thermocautery, bipolar cautery, or monopolar cautery devices. The circumcised foreskin was removed for histopathological analysis. The circumcision techniques were compared in terms of the depth of injury on the prepuce. Wound healing on the 5^th day on the circumcision plane was evaluated by using a grading scale from 0-4 and by comparing re-epithelization, granulation tissue, and collagen deposition. Blood samples were taken 1^st hour after the operation and the 5^th day, prior to the necropsy. The totals of the oxidant/anti-oxidant levels were determined. For statistical analyses, the SPSS packet program was used. Statistical significance was determined as a P value <0.05. The least trauma was with the scalpel which was comparable with the thermocautery in regard to depth of injury, epithelization, granulation tissue formation, and collagen buildup. Thermocautery group showed superior collagen proliferation compared with the monopolar cautery group, while being superior in epithelization and injury depth when compared with the bipolar cautery group. The use of thermocautery for circumcision has shown to be safe and resulted in better wound healing in rats with no apparent complications, and, if used in the human population, it may be a safe and effective technique.