Neonatal circumcision with Gomco clamp--a hospital-based retrospective study of 1000 cases.

OBJECTIVE To evaluate the impact and safety of neonatal circumcision under a uniform hospital policy using Gomco Clamp (GC). DESIGN/METHODS A retrospective analysis of 1000 consecutive cases of neonatal circumcisions done with Gomco clamp at the Armed Forces Hospital, Jubail, Saudi Arbia during the period January 1996 through December 1998. The outcome measures were the type and number of complications, incidence of inadequate circumcisions, redo procedures and the extent of parental satisfaction. RESULTS There was 1.9% incidence of overall complications (n = 19) with mild to moderate bleeding in 6 cases (31.6% of complications), which settled with further compressive dressing. There were 4 cases (21%) of superficial sepsis and 2 frenular ulcers (10.5%), which required topical antibiotics. Four babies (21%) had soft Preputial adhesions that were separated easily under topical anaesthesia. There were 3 cases (16%) of inadequate circumcisions; however only one required a redo operation after one year. The other two were found adequate at further follow-up for two years and final appearance was acceptable to parents; 99.7% parents were satisfied with the final cosmetic appearance. CONCLUSION The circumcision with Gomco clamp is safe and effective technique with reproducible results provided a particular care is taken in exact marking of the site on foreskin for excision and selecting a correct size of the clamp. Each hospital needs to develop its own policy keeping in view the population for best cosmetic results from circumcision to avoid disappointments and redo operations.