Analyze early complications rate in neonatal circumcision performed by attending physicians and residents in obstetrics and pediatrics.
Retrospective chart review of all full term neonates who had circumcision performed using Gomco or Mogen instruments during their birth hospitalization in two community-based hospitals were reviewed retrospectively. Complications were the primary outcome and were divided into major (i.e., bleeding requiring transfusion or sutures) and minor (bleeding requiring pressure or local hemostatic agents).
From January 2012 to December 2014 a total of 1071 medical records were reviewed. Gomco was the more common technique used [55.84% (598/1071)]. The overall complication rate was 3.83% (41/1071), all involving bleeding. Only 3 [7.32% (3/41)] major complications were encounter, requiring suture placement. No transfusions required. The rest were minor bleeding complications, controlled either by pressure [58.54% (24/41)], silver nitrate [26.83% (11/41) or thrombin [7.32% (3/41)]. Use of the Gomco clamp was more likely to result in bleeding than was the Mogen clamp, 5.69% (34/598) vs 2.96% (14/473), P=.03. Statistical significant difference was noted between pediatricians complication rate (11.49%), compared to OB/GYN physicians (3.08%) (P=.0002).
Neonatal circumcision is a fairly safe procedure when performed in a hospital setting by attendings or proper supervised physicians in training. The most common complication found in our cohort, was bleeding and the majority resolved with either suture or pressure. No significant major complications were found. In our hands, the Mogen clamp was associated with less bleeding than was the Gomco clamp.