Male circumcision using bone cutter with thermal cautery

Background: Bone cutter is a widely used procedure to cut the prepuce during circumcision. Aim of the study: The aim of the study was to assess the safety of circumcision of male using bone cutter with thermal cautery, including the operative time and healing time and the effect of dressing on rate of infection and bleeding. Materials and Methods: Over 20 years period from 1996 till 2015, six thousands of males were circumcised under local anesthesia (in form local infiltration of 1% plain lidocaine 5 min before circumcision and xylocaine spray after the procedure) using a bone cutter with thermal cautery, the first assistant is to fix the upper limbs, while the main assistant is to fix the knees in a fully extended position by the left hand, while the right hand used to elevate the two mosquitoes, then by using thermal cautery to cut the foreskin above the jaw of bone cutter and by using S-ring in certain situation to fix the bone cutter tightly. Results: Six thousands males were included in this study. The mean operative time was 1-2 minutes, healing time was 5-7 days, 387 cases (6.45%) developed early & late complications, 180 (3%) bleeding, 195 (3.25%) developed infection, 3 (0.05%) with mild glans injury need dressing only for 24-48 hours only 9 (0.15%) need re-circumcision later on in the same procedure. Conclusions: Bone cutter with thermal cautery circumcision is feasible with a relatively lower complications rate, shorter operative time, and short healing time.