User:Petersmillard/sandbox
From Wikipedia, the free encyclopedia
Unicirc is a single-use-only, disposable surgical instrument, which permits rapid minimally-invasive circumcision of males from infancy to adulthood. Unicirc uses topical instead of injectable anesthetic, is completed rapidly in a single visit without sutures, and heals by primary intention.
| Inception | 2013 |
|---|---|
| Manufacturer | Kapasmed |
| Available | Sub-Saharan Africa |
| Website | Unicircglobal.com |
History and usage
Unicirc was developed by a team led by Cyril Parker, Family Physician, and Elisabeth Pillgrab-Parker, project development specialist, in Cape Town, S. Africa. It is a single-use-only metal and plastic disposable surgical instrument.
After the foreskin is retracted, the Unicirc transparent bell is placed over the glans at the level of the corona and the foreskin is then replaced into the anatomic position. The yoke is placed over the bell and the screws are tightened, creating circumferential compression at the base of the foreskin for 5 minutes, which fuses the mucosal and skin surfaces. This allows for bloodless excision of the foreskin. Other than a scalpel, no other surgical instruments are needed. The fused skin edges are sealed with cyanoacrylate tissue adhesive to allow healing by primary intention. The procedure uses topical anesthesia cream, does not require sutures, and is completed in 9 minutes with no subsequent visits needed.[1]
Advantages
Unicirc is a single-use-only instrument with a locking device that prevents reuse, eliminating the possibility of transmission of infection from one person to another.[2] It can be used in all age groups. Topical anesthetic cream is used instead of injectable anesthetic and the use of cyanoacrylate tissue adhesive obviates the need for sutures. It is quick to perform and is completed in a single visit, healing by primary intention is rapid, and cosmetic results are excellent.[1]
Unicirc can also be used in males when the foreskin is tight or adherent to the glans (phimosis), after a dorsal slit (similar to that performed in newborns). Frenulectomies can be performed under topical anesthetic immediately prior to Unicirc circumcision.
An international group of researchers estimated that compressive instruments (like Unicirc and Gomco) could displace up to 85% of surgical circumcisions.[3] A meta-analysis of randomized controlled trials suggested that compressive instruments were associated with less blood loss, more rapid healing, and less pain compared to other techniques.[4]
The risk of tetanus following surgical circumcision is low, and the risk with Uncirc is likely even lower, as there is never an open wound, no necrotic material, and the fused line of excision is sealed with cyanoacrylate, which has antibacterial properties.
Complications
As a result of intraoperative and postoperative bleeding episodes using Unicirc version 1, the developers made changes to the tightening mechanism. The current version 2 has the same bleeding risk as surgical circumcision.[1] A small proportion of patients experience partial wound separation in the following week, which does not require treatment.[1]