Absract
Introduction
Tissue glue has been used for circumcision in children with promising results. We aimed to evaluate the efficacy of tissue glue in pediatric circumcision.
Materials and Methods
A systematic review and meta-analysis of the English literature (1997-2017) was conducted according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement on children that underwent circumcision with tissue glue. Meta-analysis was conducted using RevMan 5.3, Comprehensive Meta-Analysis 2 and MedCalc 18. P values < 0.05 were considered significant.
Results
The search returned 15 studies for a total 4567 circumcisions of which 3045 (66%) were performed with tissue glue. Systematic review: Overall complications rates were 4.3% (tissue glue) and 5.9% (sutures). Use of tissue glue was associated with reduced post-operative pain; better cosmetic results and reduced cost. Meta-analysis: There was no difference between the incidence of total post-operative complications (RR 0.86 [CI: 0.62 – 1.19]; p = 0.36]) and wound infection/dehiscence between the two groups (RR 0.95 [CI: 0.59 – 1.56]; p = 0.85). Post-operative bleeding/hematoma formation were reduced with the use of tissue glue (RR 0.55 [CI: 0.32 – 0.95]; p = 0.03). Tissue glue also significantly shorten the operative time (MD -0.22 [CI: -0.39 – -0.05]; p = 0.01).
Conclusions
Incidence of post-operative bleeding/hematoma formation in pediatric circumcision is reduced with the use of tissue glue. Tissue glue has reduced operative time; furthermore, it might be associated with reduced post-operative pain, less overall cost and superior cosmetic results.
Keywords
circumcision; children; tissue glue
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