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The efficacy of tissue glue in pediatric circumcision wound approximation: A meta-analysis of randomized controlled
Yufi Aulia Azmi1, Niwanda Yogiswara1, Johan Renaldo1
1Department of Urology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia; Dr. Soetomo General-Academic Hospital, Surabaya, East Java, Indonesia.
Insights
Tissue glue significantly reduces circumcision operation time and pain duration and severity in children compared to absorbable sutures. However, complication rates remain similar between the two methods.
Area of Science:
- Pediatric Surgery
- Wound Closure Techniques
- Medical Adhesives
Background:
- Tissue glue is increasingly utilized in pediatric procedures.
- Its efficacy in pediatric circumcision requires direct comparison with traditional methods.
Purpose of the Study:
- To compare the effectiveness of tissue glue versus absorbable sutures for wound approximation in pediatric circumcision.
Main Methods:
- A systematic review and meta-analysis adhering to PRISMA guidelines.
- Included six trials with 817 pediatric patients.
- Statistical analysis performed using RevMan 5.4.
Main Results:
- Tissue glue significantly decreased operation duration (MD -7.98; p=0.0003) and pain severity (SMD -0.57; p<0.00001).
- Reduced duration of postoperative pain was observed with tissue glue (MD -2.33; p<0.00001).
- No significant differences in bleeding, infection, dehiscence, or overall complications were found.
Conclusions:
- Tissue glue is a viable alternative for pediatric circumcision wound closure.
- It offers benefits in reduced operative time and postoperative pain.
- Further research may explore long-term outcomes and specific patient populations.
Introduction:
Tissue glue has been examined extensively for its effectiveness in pediatrics, and the findings are good. The purpose of this research was to examine the effectiveness of tissue glue compared to absorbable sutures for wound approximation in pediatric circumcision.
Methods:
A systematic review and meta-analysis on children who had circumcision using tissue glue and absorbable suture were done in line with the PRISMA criteria. RevMan 5.4 was used to perform the meta-analysis. The mean differences for continuous and dichotomous data are determined using inverse variance, and the odds ratio is calculated using the Mantel-Haenszel technique.
Results:
The inclusion criteria were met by six trials containing a total of 817 patients. According to the analysis, tissue glue significantly reduces the duration of the operation (MD - 7.98; 95% CI -12.35, -3.62; p = 0.0003), pain severity (SMD -0.57; 95%CI -0.80, -0.32; p < 0.00001) and the duration of pain (MD - 2.33; 95% CI -2.57, -2.08; p < 0.00001) compared to absorbable suture. However, we found that there was no significant difference in the incidence of postoperative bleeding, infection, dehiscence, or overall complication when comparing tissue glue to traditional suture.
Conclusion:
Our systematic review and meta-analysis using the most recent data suggest that tissue glue usage might reduce the operation time, as well as the intensity and duration of postoperative pain.
