THE NEW ERA OF DISPOSABLE CIRCUMCISION DEVICE
A SAFE, EASY AND EFFECTIVE CIRCUMCISION IN CHILDREN
A SAFE, EASY AND EFFECTIVE CIRCUMCISION IN CHILDREN
Solehring is a bullet-like plastic device made from a material called PC makrolon 2458 which is FDA approved. There are two parts to the device; the ring and the cap. The ring has an anti-slip effect that prevents the string from slipping. It fits easily onto the finger for a firm grip, making it easy to twist the cap open. Its transparent feature makes the glans penis visible. The ring is very light on the shaft and prevents injury when retracted. It also provides enough space for the glans penis to dilate during micturition, preventing urine retention that normally causes infection.
The cap functions as a protection. Similar to the ring, the cap is transparent, making the glans penis visible and prevents any injury during the procedure.
The string is made from non-absorbable synthetic cotton which is soft and unlikely to cause an allergic reaction making is safe for the human skin. It provides adequate tension and grip so the person performing the circumcision can do it effortlessly.
Solehring’s unique features, materials, design and concept is safe and easy, and addresses the common complications and infections that happen during circumcision.
Solehring was awarded the silver medal during PECIPTA 2015 at KLCC. The Solehring design and idea won the silver medal at iCAN 2016 in Toronto, Canada. The Solehring business module made it to the finals of the SUPERB Grant by TERAJU.
Circumcision is the oldest surgical procedure practiced until now. It was first described by ancient Egyptian on written wall of the pyramid. Male circumcision consists of the surgical removal of some, or all, of the foreskin (or prepuce) from the penis. It is one of the most common procedures in the world. Elective circumcision regularly performed soon after the newborn period till adolescent. In a large retrospective review of Nationwide Inpatient Sample, estimated rates of newborn circumcision have risen from 48.3% nationwide in this period 1988-1991 to 61.1% of male newborn from 1997 – 2001. This represent an increases in incidence of approximately 6.8% per year.
The most commonest indication of male circumcision are includes foreskin related diseases, cosmetic, ritual or religion and hygiene purposes. Foreskin related disease are includes , phimosis or paraphimosis, ulcers and zip-trauma . There is compelling evidence that male circumcision reduces the risk of heterosexually acquired HIV infection in men by approximately 60%. Three randomized controlled trials have shown that male circumcision provided by well trained health professionals in properly equipped settings is safe. WHO/UNAIDS recommendations emphasize that male circumcision should be considered an efficacious intervention for HIV prevention in countries and regions with heterosexual epidemics, high HIV and low male circumcision prevalence.
Methods of circumcision In Malaysia
In Malaysia, There are several methods have been used for circumcision:
Originally this clamp was developed in the Netherlands by a company called Circumvent BV; their US agent obtained FDA approval for use of the Smart Klamp in the USA. Despite the reference in FDA documentation to adult sizes, the company’s prototype adult model never went into mass production. On a historical note: The prototype adult SmartKlamp had a clamping ring which was angled in a way now found in the Ali’s Klamp device.
Sizes now available are 10, 13, 16, 20 and 25mm diameter. The Size-O-Meter device has been redesigned accordingly. The 25mm size can be used mid-puberty, but it is not suitable for a mature adult male.
The Ali’sKlamp was first marketed in 2007 as a disposable Male circumcision device designed for circumcising aesthetically, quickly, without blood loss and without the use of suture from Turkish manufacturer.
Ismail Klamp discovered by Dr. Ismail Md Salleh from Johor Bharu . This tool is almost like any other klamp tool, this tool only has a locking mechanism with a screw system, so the installation of dams release of the tool is very easy without damaging the tool. Currently only available 2 sizes for children of Q-Tan: It resembles Ismail Clamp screws the system just locks dead (irreversible locking system) so that this instrument can not be recycled back in because the opening of this tool should be the cut.
Launched in 2006, this circumcision clamp is a single-use disposable device developed by Sunathrone BioMedical in Malaysia. The makers claim a number of significant advantages over previous designs of disposable clamps. The principal advantage appears to be the size of the device remaining on the penis for the duration of the healing period, which is considerably smaller than rival clamps. The Sunathrone Clamp comes in various sizes for use on males of all ages, from newborn to adults.
Originally marketed in 1955, the Plastibell is a disposable plastic bell-shaped object with a groove close to its edge. The bell is inserted into the preputial cavity and the foreskin is tied around it with a tight string. Blood flow to the prepuce is thereby ceased and the prepuce forward of the string is cut off. The handle is then snapped off. After several days, the prepuce caught under the string necrotizes and falls off, providing a bloodless circumcision with no open wound to become irritated or infected.
Complication of circumcision related with clamp type devices
1. Infection at the corona = 32%
2. Bleeding = 21%
3. Delayed wound healing = 21%
4. Problem with micturition = 16%
5. Injury to the penis = 21%
6. Swelling = 83%
7. Problem with penis appearance = 31%
Data source: ( E.lagarde et al : High rates of adverse events following circumcision of young adult with Tara Klamp : A randomized trials in South Africa ; March 2009, Vol.99,No.3,SAMJ )
Ring type of disposable circumcision device carries low complication rates and gives better outcome compare to clamp type
Adverse Events of a moderate or severe nature associated with PrePex were low and reversible. PrePex is feasible for mass safe male circumcision scaling up.(Uganda National Council of science and technology )
Study of 2000 PlastibellTM circumcision found a complication rate of 1.8%, the most frequent being minor infection and haemorrhage.( Al-Samarrai AYI, Moifti AB, Crankson SJ, Jawad A, Haque K, al-Meshari A. A review of a Plastibell device in neonatal circumcision in 2,000 instances. Surg Gynecol Obstet 1988; 167 (4):341-3)
1. After the circumcision procedure, the ring will stay with the patient but the glans penis and penile meatus are clearly visible. It helps during and after micturition.
2. After 2 days of the procedure, minimal swelling develops.
3. 5 days after the circumcision, the skin attached to the ring will start to turn into black color.
4. 10 days after circumcision, the ring starts to loosen from the penile and later, fall on its own.
5. If the ring is still intact to the skin after 14 days, the patient is advised to go to a nearby clinic to remove the ring by cutting out the string. It is a painless procedure which does not require any anaesthesia.
6. Throughout the process, the patient is advised to clean the ring regularly by himself using plain tap water after micturition. No dressing is required.
7. Do not put any ointment or cream throughout the process.
8. Patient is allowed to wear loose pants but not tight underwear.
9. The patient is advised to go any nearby clinic if presence of bleeding or pus discharges from the ring.