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Sunday, September 25, 2011

Circumcision Devices can be Avoided to Stay Free from Clamp Related Injuries

Posted by Dr Prahallad Panda on 12:49 PM Comments

Molly Hennessy-Fiske, Los Angeles Times, reported on September 26, 2011; Melanie Hall brought her week-old son Terrel to a Los Angeles doctor for circumcision. But after a nurse took the baby into an examining room, something went terribly wrong.
The doctor called her in from the waiting room. He had cut off most of the tip of her son's penis.
Hall sued both the doctor and the distributor of the Mogen clamp he had used to circumcise her now 8-year-old son, Terrel.
Though her claim against the physician was dismissed, Miltex Inc. and its parent company, Integra Life Sciences Holding Corp., agreed this summer to a $4.6-million settlement.
Terrel now lives with his mother in Austin, Texas. He had had two reconstructive surgeries, and will need at least two more between his teens and 20s for repair of the physical damage. Then there will be plastic surgery.
There are several such devices, which are in use for circumcision. Nearly all circumcisions in the U.S. are performed with devices like Mogen clamp, Gomco clamp or Plastibell.
plastibell circumcision day 5 postoperativeImage of Plastibell Circumcision
These days, about 56% of boys born in the U.S. are circumcised in hospitals according to the Centers for Disease Control and Prevention; apart from those done by religious leaders and others.
In August 2000, the U.S. Food and Drug Administration issued a public health notice about the Mogen and Gomco clamps after receiving about 20 injury reports a year since 1996, including lacerations, Bleeding, penile amputations and urethral injuries.

But complications continued. In the 11 years between the FDA warnings and the Hall settlement, the agency has received 139 additional reports of problems related to circumcision clamps, including 51 injuries. Twenty-one of those reports were related to Mogen clamps, all but one of which involved injuries.
In India, mostly circumcision is done in some community on religious grounds and in some others on therapeutic grounds. Except very few cases of reactive bleeding, mutilation of essential parts of penis is not seen.
There is standard method of circumcision without use of the devices; that can be safely performed under a short acting general anaesthesia or local anaesthesia. The procedure allows the surgeon to cut the foreskin under direct vision. He can secure the bleeding blood vessels then and there, leaving no chance for post-operative bleeding.
Complications of greater magnitude as in this instant case may feed fuel to the fire of the opponents of circumcision, who are echoing to stop the procedure for quite some time in certain regions of the world.
But, circumcision has its own role in many circumstances. It can be made optional choice of parents of new born.
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