Priscella S Chan1, Frank J Penna2,3, Alison Volpe Holmes2,3. 1. Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; and priscella.s.chan.med@dartmouth.edu. 2. Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; and. 3. Children's Hospital at Dartmouth-Hitchcock, Lebanon, New Hampshire.
Abstract
OBJECTIVES: Elective newborn circumcision, one of the most common surgical procedures in the world, is often performed with either the Gomco clamp or the Mogen clamp. Our aims were to determine differential circumcision revision and complication rates due to surgical technique and differences in outcomes when residents versus attending physicians performed the procedure. METHODS: We conducted a retrospective chart review of newborns who underwent elective circumcision at our children's hospital from January 2013 to June 2017 using Current Procedural Terminology codes for newborn circumcision and repair of an incomplete circumcision. We excluded patients who were initially circumcised by a physician other than a pediatrician and procedures that were performed after 31 days of age. The primary outcome was the rate of circumcision revisions. The secondary outcome was the incidence of minor and major complications. We used independent sample t tests, analysis of variance, Fisher's exact test, and logistic regression models in the analysis. RESULTS: We analyzed 979 Gomco and 718 Mogen procedures. Both groups had similar complication (26 of 1697 or 1.53%) and revision rates (8 of 1697 or 0.47%). Attending physicians and residents had similar revision rates overall, but residents using the Gomco clamp had a higher rate of revision (2 of 249 or 0.80%) than attending physicians (2 of 730 or 0.27%; P = .003). Older age at primary procedure was significantly associated with revision (P = .03). CONCLUSIONS: Elective newborn circumcision is associated with similar complication and revision rates after the use of either Gomco or Mogen clamps. There were no differences in outcomes when the procedure was performed by pediatric residents or attending pediatricians.
OBJECTIVES: Elective newborn circumcision, one of the most common surgical procedures in the world, is often performed with either the Gomco clamp or the Mogen clamp. Our aims were to determine differential circumcision revision and complication rates due to surgical technique and differences in outcomes when residents versus attending physicians performed the procedure. METHODS: We conducted a retrospective chart review of newborns who underwent elective circumcision at our children's hospital from January 2013 to June 2017 using Current Procedural Terminology codes for newborn circumcision and repair of an incomplete circumcision. We excluded patients who were initially circumcised by a physician other than a pediatrician and procedures that were performed after 31 days of age. The primary outcome was the rate of circumcision revisions. The secondary outcome was the incidence of minor and major complications. We used independent sample t tests, analysis of variance, Fisher's exact test, and logistic regression models in the analysis. RESULTS: We analyzed 979 Gomco and 718 Mogen procedures. Both groups had similar complication (26 of 1697 or 1.53%) and revision rates (8 of 1697 or 0.47%). Attending physicians and residents had similar revision rates overall, but residents using the Gomco clamp had a higher rate of revision (2 of 249 or 0.80%) than attending physicians (2 of 730 or 0.27%; P = .003). Older age at primary procedure was significantly associated with revision (P = .03). CONCLUSIONS: Elective newborn circumcision is associated with similar complication and revision rates after the use of either Gomco or Mogen clamps. There were no differences in outcomes when the procedure was performed by pediatric residents or attending pediatricians.