Neonatal plastibell circumcision: does the thread type matter? a prospective randomized study

Area of Science:

• Neonatal surgery
• Pediatric urology
• Surgical device innovation

Background:

• Plastibell is a widely used disposable device for neonatal circumcision.
• The type of thread used to secure the Plastibell may influence the ring separation time.

Purpose of the Study:

• To investigate if using polypropylene thread instead of cotton thread for Plastibell circumcision in neonates results in faster ring separation.
• To compare the safety and efficacy of polypropylene versus cotton threads in neonatal circumcision using the Plastibell device.

Main Methods:

• A prospective, randomized clinical and biomechanical study was conducted on 200 full-term male neonates.
• Circumcisions were performed by a single surgeon, with neonates randomized into two groups: one using cotton thread and the other polypropylene thread.
• Biomechanical testing evaluated the tensile properties of both thread types.

Main Results:

• The mean Plastibell ring separation time was significantly shorter with polypropylene thread (7.74 days) compared to cotton thread (8.98 days) (P < 0.001).
• Both thread types demonstrated similar complication rates.
• Polypropylene thread had a smaller diameter (0.35 mm) and higher tensile strength (457 MPa) than cotton thread (0.68 mm and 180 MPa, respectively).

Conclusions:

• Polypropylene thread facilitates faster Plastibell ring separation during neonatal circumcision than cotton thread.
• The use of polypropylene thread is safe and does not increase adverse effects.
• Further research into different thread types and sizes could potentially further reduce separation time.