To wrap or not to wrap: A retrospective review of circumcision dressing and post-procedural bleeding
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Read the article on jpedsurg.org ↗Article · Jun 2020 · 1 min read
In brief
In brief
This retrospective study of 681 pediatric circumcisions demonstrates that circumferential wrap dressings significantly reduce postoperative bleeding compared to ointment alone (2.7% vs 7.8%, p<0.01). The protective effect remained significant after controlling for age, technique, and surgeon specialty, suggesting wrap dressings should be considered standard practice.
Written by the GCMD Library team from the article.
Abstract
Introduction
Bleeding is an infrequent, but important, complication after circumcision. Our aim was to examine postoperative bleeding events after circumcision comparing patients managed with a circumferential wrap to ointment alone.
Methods
Boys ≤18 years of age who underwent circumcision at a tertiary children's hospital were retrospectively reviewed between 2017 and 2018. Postoperative bleeding was defined by phone calls, clinic or Emergency Department visits, or return to the operating room. Outcomes were examined by univariate association and multivariable modeling.
Results
Of 681 boys undergoing circumcision, 503 (74%) patients received a wrap dressing and 178 (26%) only ointment. There were 28 (4%) patients who had a postoperative bleeding event: 14/503 (2.7%) among wrap dressings and 14/178 (7.8%) among ointment alone (p < 0.01). The majority of events were phone calls related to bleeding (75%). Univariate analysis demonstrated no association between postoperative bleeding and surgeon specialty (p = 0.72), age at circumcision (p = 0.44) or technique type (p = 0.09). After controlling for age, technique type, and surgeon specialty, dressing type remained significantly associated with postoperative bleeding (OR = 2.81, p < 0.01).
Conclusion
This single-center, retrospective review found circumferential wrap dressings are associated with a decrease in bleeding events after circumcision.
Level of Evidence
III – retrospective case–control study.