TY - JOUR
T1 - The Use of Tissue Glue for Circumcision in Children
T2 - Systematic Review and Meta-analysis
AU - Martin, Amy
AU - Nataraja, Ramesh M.
AU - Kimber, Chris
AU - Pacilli, Maurizio
PY - 2018/5
Y1 - 2018/5
N2 - Objective: 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-analyses (PRISMA) statement on children who underwent circumcision with tissue glue. Meta-analysis was conducted using RevMan 5.3, Comprehensive Meta-Analysis 2, and MedCalc 18. P values <.05 were considered significant. Results: The search returned 15 studies for a total of 4567 circumcisions, of which 3045 (66%) were performed with tissue glue. The systematic review indicated that overall complication rates were 4.3% (tissue glue) and 5.9% (sutures). The use of tissue glue was associated with reduced postoperative pain, better cosmetic results, and reduced cost. Meta-analysis showed that there was no difference between the incidence of total postoperative complications (relative risk [RR] 0.86 [95% confidence interval {CI}: 0.62-1.19], P =.36) and wound infection and dehiscence between the 2 groups (RR 0.95 [95% CI: 0.59-1.56], P =.85). Postoperative bleeding and hematoma formation were reduced with the use of tissue glue (RR 0.55 [95% CI: 0.32-0.95], P =.03). Tissue glue also significantly shorten the operative time (mean difference −0.22 [95% CI: −0.39 to −0.05], P =.01). Conclusion: The incidence of postoperative bleeding and 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 postoperative pain, less overall cost, and superior cosmetic results.
AB - Objective: 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-analyses (PRISMA) statement on children who underwent circumcision with tissue glue. Meta-analysis was conducted using RevMan 5.3, Comprehensive Meta-Analysis 2, and MedCalc 18. P values <.05 were considered significant. Results: The search returned 15 studies for a total of 4567 circumcisions, of which 3045 (66%) were performed with tissue glue. The systematic review indicated that overall complication rates were 4.3% (tissue glue) and 5.9% (sutures). The use of tissue glue was associated with reduced postoperative pain, better cosmetic results, and reduced cost. Meta-analysis showed that there was no difference between the incidence of total postoperative complications (relative risk [RR] 0.86 [95% confidence interval {CI}: 0.62-1.19], P =.36) and wound infection and dehiscence between the 2 groups (RR 0.95 [95% CI: 0.59-1.56], P =.85). Postoperative bleeding and hematoma formation were reduced with the use of tissue glue (RR 0.55 [95% CI: 0.32-0.95], P =.03). Tissue glue also significantly shorten the operative time (mean difference −0.22 [95% CI: −0.39 to −0.05], P =.01). Conclusion: The incidence of postoperative bleeding and 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 postoperative pain, less overall cost, and superior cosmetic results.
UR - http://www.scopus.com/inward/record.url?scp=85043757402&partnerID=8YFLogxK
U2 - 10.1016/j.urology.2018.01.022
DO - 10.1016/j.urology.2018.01.022
M3 - Review Article
AN - SCOPUS:85043757402
VL - 115
SP - 21
EP - 28
JO - Urology
JF - Urology
SN - 0090-4295
ER -