ABSTRACT
Purpose: evaluation of plastibell device as an option for circumcision in neonates and infants
Material and Methods: between August 2002 and July 2004,800 cases had been circumcised by the authors using the plastibell device. Eighty five percent [680 boys] were circumcised before their mothers were discharged from the hospital after delivery. This was performed as an office procedure under local anesthesia. The babies were reviewed one to two weeks later by the same surgeon
Results: the mean time for executing the procedure was 5 minutes. In 584 cases [73%] the bell fell off spontaneously between the fifth and the 7th days. Complications occurred in 48 cases [6%]. Twelve cases [1.5%] had minor bleeding during the procedure. In five cases, the bell had to be taken off and circumcision proceeded in the conventional suturing technique to control bleeding. Twenty-seven cases [3.4%] had minor infection in the form of yellowish slough that responded to simple in ensures at home. The results were satisfactory for the parents in [792] cases [99%]. Eight cases developed phimosis [1%], only four cases required re-circumcision
Conclusion: plastibell device is a simple, safe and convenient option for circumcision. It is easily learned, less time consuming and having satisfactory outcome
ABSTRACT
Aim: although operative-management was the standard for blunt abdominal trauma [BAT] in children, recently a non-surgical approach was recommended for pediatric solid-organs-injuries
Methods: to determine the role of conservative approach in BAT children, we retrospectively analyze the data of children with [BAT] and solid-organs-injuries managed by the authors over 4 years
Results : from December /2000 through December /2004, 24 children with [BAT] and solid- organs-injuries were managed. Injury mechanisms were road-traffic-accidents [RTA] in 19 [79%], sport-related in 4 [17%] and falling-from-height in 1[4%]. The spleen was injured in 13 [54%]; the liver in 12 [50%], the kidneys in 3 [13%], and the adrenal-glands in 2 [8%]. Thirteen cases were managed conservatively [53%], and I 1 operatively [47%]. Operations for the spleen [6] included, splenectomy in 3 [50%], partial splenectomy in 2 [33%] and splenorraphy in 1[17%], for the liver [6], suturing tears in 4 [67%] and per hepatic packing in 2 [33%]. Four children [17%] died from their injuries; [2] severe chest-injuries, [1] spinal-fracture and [1] severe liver-injury
Conclusions: children with BAT and solid-organs injuries-can be treated without surgery if the decision is based-on their hemodynamic status and response and resuscitation. Management in pediatric-trauma-centers, with the involvement of pediatric surgeons gives the best outcome