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A new technology for the prevention of complications of male circumcision and HIV risk through contaminated parts in African children

Presented by David Tomlinson, .

D. Tomlinson1, O. Sowande2, A. Caldamone3, C. Bode4, L. Shelton5

1Brown University, Department of Family Medicine, Providence, United States, 2Obafemi Awolowo University Teaching Hospital, Pediatric Surgery, Ile-Ife, Nigeria, 3Brown University, Pediatric Urology, Providence, United States, 4Lagos University Teaching Hospital, Pediatric Surgery, Lagos, Nigeria, 5Brown University, Engineering, Providence, United States

Background: The World Health Organization has recommended that male circumcision be considered as an intervention to reduce the risk of HIV infection. There is now an urgent need for an inexpensive, easy to use, circumcision device that can better protect infants from procedural related injury and help prevent HIV transmission through contaminated parts.
Methods: We have developed a circumcision device that is disposable and allows for placement of a shield without making a dorsal slit. The clamp of the device only operates if an appropriately sized shield is in place and delivers a circumferential crush and cut with one actuation. The internally protected integrated blade is precisely controlled by the device and becomes locked within the housing, along with the shield, prohibiting reuse. We evaluated the shield in 83 male infants, aged 3 days to 3 months, and tested the clamp in 61 of these infants.
Results: The shield was successfully placed in all 83 infants without making a dorsal slit. In 61 of these cases the clamp was used to crush the foreskin and provided adequate hemostasis following surgical incision of the prepuce. In 42 of these cases the clamp was used to make both the crush and cut.
Conclusion: We have demonstrated that this disposable device can safely crush and cut the foreskin using a shield and internal blade without the need for a dorsal slit, concern for mismatched parts, or the need for hemostats, scissors, and a scalpel; thereby reducing the risk of urethral injury, penile laceration, and infection through contaminated device parts.

Additional information

Our goal has been to develop a device that can better protect patients from injury during male circumcision. We have focused on an engineering solution, not a procedural one. The device itself is designed to protect patients from injury, independent of the experience level of the user. It has been designed to be entirely disposable, requiring no reprocessing, and easy to use.

We welcome questions and comments: David_Tomlinson@Brown.edu

More information is available at the manufacturer’s web site: www.AccuCirc.com

Atraumatic Circumcision Device - Poster
More information is available at the manufacturer''s web site: www.AccuCirc.com

Disclaimer: This additional information has been submitted by the abstract author after the abstract has been accepted for the conference and has not been reviewed by the conference organizers.

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